Minor Med Care, LLC
Organization Active NPI Primary Care Clinic/Center · Jackson, MS
NPI 1407968738 · NPPES record last updated Apr 10, 2026
Key facts
- NPI
- 1407968738
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- License
- 09740 (MS)
- Legal business name
- MINOR MED CARE, LLC
- Practice address
- 2860 McDowell Road Ext
Jackson, MS 39204-4238 - Phone
- (601) 372-1117
- Fax
- (601) 373-3004
- NPI assigned
- Aug 31, 2006
- Organization subpart
- No
Authorized official
- Name
- John Duke
- Title
- Coo
- Phone
- (601) 665-4162
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Practitioners 174
-
Jennifer Graves Borum, AGACNP-BC
-
Yolanda M Bush, FNP
-
Raven M. Campbell-Smith, FNP-C
-
Amanda Monique Carson-Griffin, FNP-BC
-
Tammarin S Collins, FNP-BC
-
Lindsey Cosgrove, LCSW
-
Katrina Renae Cotton, FNP
-
Tasha Nicole Dampier, FNP
-
Hailey Ott Davis, FNP-C
-
James M Dew, MD
-
Flora K. Green, AGPCNP
-
James Hawley, NP-C
-
Amanda Mae Howard, FNP
-
Katherine W Hughes, FNP
-
Courtney Jeffus, FNP
-
Brandi Davis Johnston, NURSE PRACTITIONER
-
Jenifer Justice, CRNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 25D0318086 | Minor Med Care | Certificate of waiver | Dec 26, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040313000147 | MS | Part B Supplier - Clinic/Group Practice | 7618866021 |
Receives reassigned benefits from 166 practitioners 1 other NPI on this enrollment Practice locations: Jackson, MS; Raymond, MS |
National Provider Directory
- Tax ID family
- Minor Med Care LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | 09740 | MS | Yes |
Addresses
Primary practice location
2860 McDowell Road Ext
Jackson, MS 39204-4238
Mailing address
215 Katherine Dr Ste a
Flowood, MS 39232-9588
Phone (601) 665-4162
Other providers in Jackson, MS
- Latricia Eubanks Mimbs
- Tiffany Nicole Mims
- Mindful Solutions, LLC
- Billy E. Mink Jr.
- Vicky Dianne Minninger
- Candy D Minor
- Garrett McTyre Minor
- Meagan A Minor
- Melissa N Minor
- Miracle Care Hospice, Inc.
All providers in Jackson, MS · Primary Care Clinic/Center in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2026. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.