Magnolia Medical Clinic LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MAGNOLIA MEDICAL CLINIC LLC

Practice address

431 Broad St
Columbia, MS 39429-3056

Phone

(601) 736-8212

NPI assigned

Jul 23, 2024

Last updated

Jul 23, 2024By 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

Dr. Kristyn Bumpers, PHARM. D.NPI 1790188159

Title

Pharmacist

Phone

(601) 441-4400

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kristyn McDaniel Bumpers, PHARMD

  • Pharmacist
  • Columbia, MS
  • NPI 1790188159
  NPD Authorized official

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

{
    "created_epoch": "1721692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721692800000",
    "number": "1356179295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 HIGHPOINTE DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394029536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 BROAD ST",
            "city": "COLUMBIA",
            "state": "MS",
            "postal_code": "394293056",
            "telephone_number": "601-736-8212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-23",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A",
        "authorized_official_last_name": "BUMPERS",
        "authorized_official_first_name": "KRISTYN",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "601-441-4400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM. D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Love and Compassion Healthcare Services
• James Lowe
• Mia Antionettte Luter, LPTA
• Yulonda Luter
• Jeremy S Lynn, LPTA
• Magnolia Medshoppe LLC (Shepard's Discount Drugs)
• Marion County School District
• Marion General Hospital
• Marion General Hospital
• Marion General Hospital

• Clinic/Center in Columbia, MS
• Providers in Columbia, MS by specialty
• Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.