Magnolia Primary Care

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

MAGNOLIA PRIMARY CARE

Practice address

202 Alcorn Dr
Corinth, MS 38834-9701

Phone

(662) 287-4481

Fax

(662) 287-4368

NPI assigned

May 11, 2017

Last updated

Jan 23, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

MAGNOLIA REGIONAL HEALTH CENTERAs reported in NPPES

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

Authorized official

Name

Ronny D. Humes

Title

Chief Executive Officer

Phone

(662) 293-7664

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Part of

Magnolia Regionl Health

Locations

Practitioners 3

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.

• Emily Dianne Feltman, FNP-C

  • Family Nurse Practitioner
  • Burnsville, MS
  • NPI 1144951153

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Jennifer Elaine Pickens, FNP-BC

  • Family Nurse Practitioner
  • Corinth, MS
  • NPI 1053884106
  Medicare reassignment Care Compare group NPD
• Alphonsus Ligouri Flannery, MD

  • Family Medicine Physician
  • Corinth, MS
  • NPI 1104899129
  Medicare reassignment NPD

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548201600000",
    "number": "1437685278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 ALCORN DR STE 2C",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349073",
            "telephone_number": "662-293-7266",
            "fax_number": "662-293-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 ALCORN DR",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349701",
            "telephone_number": "662-287-4481",
            "fax_number": "662-287-4368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA PRIMARY CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MAGNOLIA REGIONAL HEALTH CENTER",
        "enumeration_date": "2017-05-11",
        "last_updated": "2019-01-23",
        "status": "A",
        "authorized_official_last_name": "HUMES",
        "authorized_official_first_name": "RONNY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "662-293-7664"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05252561",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Magnolia Medical Clinic
• Magnolia Nephrology Clinic
• Magnolia Orthopaedics & Sports Medicine, P.a.
• Magnolia Pediatric Clinic
• Magnolia Physician Services, Inc
• Magnolia Professional Associates
• Magnolia Professional Billing
• Magnolia Regional Behavioral Health Services
• Magnolia Regional Community Care Clinic
• Magnolia Regional Health Center (MRHC - Home Health)

• General Practice Physician in Corinth, MS
• Providers in Corinth, MS by specialty
• General Practice Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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.