Rankin Primary Care Clinic, PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

16492 Issued in MS

Legal business name

RANKIN PRIMARY CARE CLINIC, PA

Practice address

103 Service Dr
Brandon, MS 39042-2401

Phone

(601) 824-1491

Fax

(601) 825-9504

NPI assigned

Apr 8, 2008

Last updated

Apr 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Thomas L Ellingson, MD

Title

Owner

Phone

(601) 824-1491

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1467625665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1959",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390431959",
            "telephone_number": "601-824-1491",
            "fax_number": "601-825-9504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 SERVICE DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422401",
            "telephone_number": "601-824-1491",
            "fax_number": "601-825-9504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANKIN PRIMARY CARE CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "ELLINGSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-824-1491",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "16492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015199",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rankin Emergency Group LLC
• Rankin Family & Sports Medicine
• Rankin Family Practice Inc
• Rankin Medical Center
• Rankin Plastic Surgery Center
• Fonda Lovevette Readus, D.C.
• Red Hills Emergency Physicians
• Ayana Denise Red, FNP
• Bruce Anthony Reed III, PHARMD
• Courtney Helen Reed, MSW

• Internal Medicine Physician in Brandon, MS
• Providers in Brandon, MS by specialty
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.