Mid-South Convenient Care, PLLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

MID-SOUTH CONVENIENT CARE, PLLC

Practice address

521 Hwy 51 North
Ripley, TN 38063

Phone

(731) 286-6611

NPI assigned

Nov 27, 2013

Last updated

Aug 2, 2017By 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

Pankaj Srivastava, MDNPI 1487655957

Title

Owner

Phone

(731) 445-4987

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Pankaj Srivastava, MD

  • Internal Medicine Physician
  • Dyersburg, TN
  • NPI 1487655957
  Authorized official Same address or phone

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

{
    "created_epoch": "1385510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501632000000",
    "number": "1477984508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 US HIGHWAY 51 BYP E",
            "address_2": "SUITE B",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242127",
            "telephone_number": "731-286-1900",
            "fax_number": "731-286-1939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 HWY 51 NORTH",
            "city": "RIPLEY",
            "state": "TN",
            "postal_code": "38063",
            "telephone_number": "731-286-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-SOUTH CONVENIENT CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-27",
        "last_updated": "2017-08-02",
        "status": "A",
        "authorized_official_last_name": "SRIVASTAVA",
        "authorized_official_first_name": "PANKAJ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "731-445-4987",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD0000034709",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole G Martin, PHARM.D.
• Cynthia M. Mashburn, APRN, BC, FNP
• Mays-Dunavant Drugs Inc
• William Haywood Mays Jr., DPH
• Tonya Ward Medford, RN
• Nicole M. Mills, O.D., FAAO
• Felicia Gail Mitchell, RN
• Tracy Schneider Morris, DDS
• Myeyedr Optometry of Tennessee, LLC (MyEyeDr)
• Damien Eric Nethery, LCSW

• Rural Health Clinic/Center in Ripley, TN
• Providers in Ripley, TN by specialty
• Rural Health Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.