Organization Active NPI

Whole Family Care PLLC

  • Family Medicine Physician
  • Vancleave, MS
National Provider Identifier
1417730474
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WHOLE FAMILY CARE PLLC
Practice address
10404 Tucker Rd
Vancleave, MS 39565-7922
Phone
(228) 354-9505
NPI assigned
Aug 15, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Authorized official

Name
Jessie Lindsey, NP-CNPI 1265884175
Title
Nurse Practitioner/Owner
Phone
(770) 356-0116

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

10404 Tucker Rd
Vancleave, MS 39565-7922

Mailing address

8912 Seaman Rd
Vancleave, MS 39565-9286

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231024001492 MS Part B Supplier - Clinic/Group Practice 7719333079 Receives reassigned benefits from 1 practitioner
Practice locations: Vancleave, 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
25D2199805Whole Family Care PLLC10404 Tucker Rd, Vancleave, MS 39565Certificate of waiverNov 9, 2026

National Provider Directory

National Provider Directory

Locations

10404 Tucker Rd
Vancleave, MS 39565
Phone (228) 354-9505

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693526400000",
    "number": "1417730474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8912 SEAMAN RD",
            "city": "VANCLEAVE",
            "state": "MS",
            "postal_code": "395659286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10404 TUCKER RD",
            "city": "VANCLEAVE",
            "state": "MS",
            "postal_code": "395657922",
            "telephone_number": "228-354-9505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLE FAMILY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A",
        "authorized_official_last_name": "LINDSEY",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER/OWNER",
        "authorized_official_telephone_number": "770-356-0116",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancleave, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.