First Intermed Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FIRST INTERMED CORPORATION

Doing business as

MEA Medical Clinics

Practice address

1132 Highway 49 S
Richland, MS 39218-9446

Phone

(601) 664-1620

Fax

(601) 664-1624

NPI assigned

Jul 10, 2006

Last updated

Feb 1, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tonya Jordan

Title

Physician Services Coordinator

Phone

(601) 898-7535

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• MEA Medical Clinics Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201824000000",
    "number": "1346274354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 HIGHWAY 49 S",
            "city": "RICHLAND",
            "state": "MS",
            "postal_code": "392189446",
            "telephone_number": "601-664-1620",
            "fax_number": "601-664-1624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 HIGHWAY 49 S",
            "city": "RICHLAND",
            "state": "MS",
            "postal_code": "392189446",
            "telephone_number": "601-664-1620",
            "fax_number": "601-664-1624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST INTERMED CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2008-02-01",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "PHYSICIAN SERVICES COORDINATOR",
        "authorized_official_telephone_number": "601-898-7535"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015301",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH7890",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEA Medical Clinics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Tammy F. Faulkner-Craig, DNP, FNP-BC
• First Choice Medical Supply, LLC
• Laurin Suzanne Folmar, OT
• Kelli Marie Foster, APRN NP-C
• Daniel Ray Gardner
• Ashlyn Gustafson
• Anthony Todd Harris II, PHARMD

• Family Medicine Physician in Richland, MS
• Providers in Richland, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.