Gloster North Family Medical Clinic Inc

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R866369 Issued in MS

Legal business name

GLOSTER NORTH FAMILY MEDICAL CLINIC INC

Practice address

1714 N Gloster St
Tupelo, MS 38804-1216

Phone

(662) 841-5086

Fax

(662) 841-5088

NPI assigned

Nov 20, 2006

Last updated

Aug 22, 2020By 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

Ms. Mary Anne Mason, APRN, BC

Title

Owner

Phone

(662) 841-5086

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356415244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1714 N GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388041216",
            "telephone_number": "662-841-5086",
            "fax_number": "662-841-5088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 N GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388041216",
            "telephone_number": "662-841-5086",
            "fax_number": "662-841-5088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLOSTER NORTH FAMILY MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-841-5086",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN, BC"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R866369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larhonda K Glass, LSW
• Melissa Leigh Glasson, LSW
• Francine Glenn, NP
• Guy Coleman Glenn, PHARMD
• Jacob Gloer
• Stephanie Glover, MSN AGNP-C
• Alisha Goff, OTR
• Gwenda Faye Goggin, P.A.
• Dylan Goin
• Shawonna Lynn Goins

• Nurse Practitioner in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.