NPIMap

Organization Active NPI

Ms Care Clinic, Inc

  • Clinic/Center
  • Ridgeland, MS
National Provider Identifier
1376168500
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
MS CARE CLINIC, INC
Practice address
625 S Pear Orchard Rd Ste B
Ridgeland, MS 39157-4836
Phone
(601) 850-2200
Fax
(601) 420-0223
NPI assigned
Jun 12, 2020
Last updated
Jul 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Authorized official

Name
Dr. Amanda Greene, DNP, NP-CNPI 1083040562
Title
Ceo/President
Phone
(601) 499-0282

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
Clinic/Center 261Q00000X Primary
Neurology Physician 2084N0400X

Addresses

Primary practice location

625 S Pear Orchard Rd Ste B
Ridgeland, MS 39157-4836

Mailing address

625 S Pear Orchard Rd Ste B
Ridgeland, MS 39157-4836
Phone (601) 499-0282

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Ridgeland Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200625002966 MS Part B Supplier - Clinic/Group Practice 7113349812 Receives reassigned benefits from 4 practitioners
Practice locations: Ridgeland, MS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1591920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595894400000",
    "number": "1376168500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 S PEAR ORCHARD RD STE B",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391574836",
            "telephone_number": "601-499-0282",
            "fax_number": "601-420-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S PEAR ORCHARD RD STE B",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391574836",
            "telephone_number": "601-850-2200",
            "fax_number": "601-420-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MS CARE CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-12",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "601-499-0282",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, NP-C"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Ridgeland",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "625 S Pear Orchard Rd Ste B",
            "city": "Ridgeland",
            "state": "MS",
            "country_code": "US",
            "postal_code": "391574836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.