Camden Community Family Health Clinic, Inc.

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

License

R860655 Issued in MS

Legal business name

CAMDEN COMMUNITY FAMILY HEALTH CLINIC, INC.

Practice address

1493 Highway 17
Camden, MS 39045-9524

Phone

(601) 859-2999

Fax

(601) 859-2999

NPI assigned

Jul 17, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Linda P. Chambers, FNP-BCNPI 1023186038

Title

Family Nurse Practitioner/President

Phone

(601) 859-2999

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 2

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

• Linda Peterson Chambers, FNP

  • Family Nurse Practitioner
  • Camden, MS
  • NPI 1023186038
  Medicare reassignment NPD Authorized official
• Jessica Yvette Tucker, FNP

  • Family Nurse Practitioner
  • Jackson, MS
  • NPI 1225545163
  NPD (past)

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342483200000",
    "number": "1437404241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29",
            "city": "SHARON",
            "state": "MS",
            "postal_code": "391630029",
            "telephone_number": "601-859-2999",
            "fax_number": "601-859-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1493 HIGHWAY 17",
            "city": "CAMDEN",
            "state": "MS",
            "postal_code": "390459524",
            "telephone_number": "601-859-2999",
            "fax_number": "601-859-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMDEN COMMUNITY FAMILY HEALTH CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-17",
        "last_updated": "2012-07-17",
        "status": "A",
        "authorized_official_last_name": "CHAMBERS",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER/PRESIDENT",
        "authorized_official_telephone_number": "601-859-2999",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "MS",
            "license": "R860655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "500002278",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "Q74410",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11890942",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03581557",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valencia Reynolds Beamon, RPT
• Linda Peterson Chambers, FNP
• Hands Helping Hands
• Lets Move Physical Therapy and Wellness Inc
• Premier Family Medicine, PLLC
• Geisha Smith

• Community Health Clinic/Center in Camden, MS
• Providers in Camden, MS by specialty
• Community Health Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; 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.