Quitman Community Hospital
Organization Active NPI Clinic/Center · Marks, MS
NPI 1346973625 · NPPES record last updated Nov 1, 2023
Key facts
- NPI
- 1346973625
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- QUITMAN COMMUNITY HOSPITAL
- Practice address
- 340 Getwell St
Marks, MS 38646-9785 - Phone
- (662) 388-0700
- Fax
- (662) 388-0707
- NPI assigned
- Jul 5, 2022
- Organization subpart
- Yes
- Parent organization (as reported)
- QUITMAN COMMUNITY HOSPITAL
Authorized official
- Name
- Barbara Conway
- Title
- Credentialing
- Phone
- (662) 357-3883
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 5
Practitioners 12
-
Brandon Goldsmith, FNP
-
Norman Jenkins, FNP
-
Jayce Miskel, M.D.
-
Brian Keith Wall, MD
-
Jesse Williams, NURSE PRACTITIONER
-
Mya Sha'Kira Williams, LCSW
-
April Nichols, FNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220107001041 | MS | Part B Supplier - Clinic/Group Practice | 7012306830 |
Receives reassigned benefits from 24 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Marks, MS |
National Provider Directory
- Tax ID family
- Quitman Community Hospital
- Part of
- Quitman Community Hospital
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes | ||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
340 Getwell St
Marks, MS 38646-9785
Mailing address
340 Getwell St
Marks, MS 38646-9785
Phone (662) 388-0700
Other names
- Quitman Family & Specialty Clinic
Other providers in Marks, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.