Organization Active NPI

Primary Care Clinic of Ripley PA

  • Family Medicine Physician
  • New Albany, MS
National Provider Identifier
1356312623
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PRIMARY CARE CLINIC OF RIPLEY PA
Practice address
460 W Bankhead St
New Albany, MS 38652-3319
Phone
(662) 539-7444
Fax
(662) 837-3760
NPI assigned
Jan 27, 2006
Last updated
Aug 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Authorized official

Name
Troy Reuben Cappleman, MDNPI 1952371387
Title
Ao
Phone
(662) 539-7444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X

Addresses

Primary practice location

460 W Bankhead St
New Albany, MS 38652-3319

Mailing address

460 W Bankhead St
New Albany, MS 38652-3319
Phone (662) 539-7444

Other identifiers 1

IdentifierTypeStateIssuer
09015964MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040420001420 MS Part B Supplier - Clinic/Group Practice 5698761302 Receives reassigned benefits from 8 practitioners
Practice locations: New Albany, MS; Ripley, MS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D1009442Primary Care Clinic of Ripley460 West Bankhead, New Albany, MS 38652Certificate of waiverFeb 13, 2027

National Provider Directory

National Provider Directory

Locations

460 W Bankhead St
New Albany, MS 38652
Phone (662) 534-4783

1009 City Ave N
Ripley, MS 38663
Phone (662) 539-7444

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1356312623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 W BANKHEAD ST",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386523319",
            "telephone_number": "662-539-7444",
            "fax_number": "662-837-3760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 W BANKHEAD ST",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386523319",
            "telephone_number": "662-539-7444",
            "fax_number": "662-837-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE CLINIC OF RIPLEY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-27",
        "last_updated": "2024-08-12",
        "certification_date": "2024-07-18",
        "status": "A",
        "authorized_official_last_name": "CAPPLEMAN",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "REUBEN",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "662-539-7444",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015964",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.