Physicians and Surgeons

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

PHYSICIANS AND SURGEONS

Doing business as

Grenada Doctors Clinic

Practice address

1732 Commerce St
Grenada, MS 38901-4615

Phone

(662) 226-2021

Fax

(662) 226-1516

NPI assigned

Jul 29, 2006

Organization subpart

No

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

Authorized official

Name

Misty Jones

Title

Office Manager

Phone

(662) 226-2021

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Grenada Doctors Clinic Doing business as

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1447264882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1732 COMMERCE ST",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389014615",
            "telephone_number": "662-226-2021",
            "fax_number": "662-226-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1732 COMMERCE ST",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389014615",
            "telephone_number": "662-226-2021",
            "fax_number": "662-226-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS AND SURGEONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MISTY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "662-226-2021"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RIVERBEND",
            "identifier": "253915",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09014089",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grenada Doctors Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James Walter Parrett Jr., PHARM.D.
• Elizabeth Annette Patton, PHARM D
• James Michael Pegg, O.D.
• Shonda Jacqueline Phelon, C.F.N.P.; P.M.H.N.P
• James R Philley, DMD
• Karen W Plunkett, M.D.
• Felicia Faye Poe, D.C.
• Kimberly Paige Porter, PHARMD
• Valiparambil Balakrishnan Praveen Kumar, M.D.
• Providence PCC of Grenada, LLC

• Rural Health Clinic/Center in Grenada, MS
• Providers in Grenada, MS by specialty
• Rural Health Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.