NPIMap

Organization Active NPI

The Clinic at Farmers Medshoppe

  • Primary Care Clinic/Center
  • Foxworth, MS
National Provider Identifier
1487972568
Registry record updated Oct 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
THE CLINIC AT FARMERS MEDSHOPPE
Practice address
62 Highway 587
Foxworth, MS 39483
Phone
(601) 424-3540
Fax
(601) 424-3544
NPI assigned
May 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2013

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

Authorized official

Name
Mr. Clayton A. Farmer
Title
Owner
Phone
(601) 424-3540

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X MS Primary
Rural Health Clinic/Center 261QR1300X MS

Addresses

Primary practice location

62 Highway 587
Foxworth, MS 39483

Mailing address

P.O. Box 669
Foxworth, MS 39483
Phone (601) 424-3540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100720000325 MS Part B Supplier - Clinic/Group Practice 2466584982 Receives reassigned benefits from 9 practitioners
Practice locations: Foxworth, MS

National Provider Directory

National Provider Directory

Locations

96 Highway 587
Ste B
Foxworth, MS 39483

62 Highway 587
Ste B
Foxworth, MS 39483

62 Highway 587
Foxworth, MS 39483
Phone (601) 424-3540

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1273708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381276800000",
    "number": "1487972568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 669",
            "city": "FOXWORTH",
            "state": "MS",
            "postal_code": "39483",
            "telephone_number": "601-424-3540",
            "fax_number": "601-424-3544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 HIGHWAY 587",
            "city": "FOXWORTH",
            "state": "MS",
            "postal_code": "39483",
            "telephone_number": "601-424-3540",
            "fax_number": "601-424-3544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CLINIC AT FARMERS MEDSHOPPE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-13",
        "last_updated": "2013-10-09",
        "status": "A",
        "authorized_official_last_name": "FARMER",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-424-3540",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MS",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MS",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Foxworth, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; 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.