NPIMap

Organization Active NPI

Nursemed LLC

Doing business as NurseMed 2

  • Rural Health Clinic/Center
  • Baldwyn, MS
National Provider Identifier
1497820310
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
R622176 Issued in MS
Legal business name
NURSEMED LLC
Doing business as
NurseMed 2
Practice address
1031 Northridge Rd
Baldwyn, MS 38824-1173
Phone
(662) 365-9305
Fax
(662) 365-9304
NPI assigned
Nov 24, 2006
Last updated
Dec 8, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

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

Authorized official

Name
Mr. Anita J Turner, FNPNPI 1356335764
Title
Owner
Phone
(662) 365-9305

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X R622176 MS Primary

Addresses

Primary practice location

1031 Northridge Rd
Baldwyn, MS 38824-1173

Mailing address

1031 Northridge Rd
Baldwyn, MS 38824-1173
Phone (662) 365-9305

Other identifiers 1

IdentifierTypeStateIssuer
06403005MedicaidMS

Other names 1

  • NurseMed 2 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20030818000030 MS Part A Provider - Rural Health Clinic 5294646782 Practice locations: Baldwyn, MS
O20050105000262 MS Part B Supplier - Clinic/Group Practice 5294646782 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
Practice locations: Ripley, MS; Baldwyn, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497820310. Details of each certification follow.

Rural health clinic certification: CCN 258972

Legal name
NURSEMED LLC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 16, 2003
Last certification
Aug 31, 2023
Ownership / control type
1A
Organization structure
CorporationProprietary
Incorporated
Aug 2, 1990 in MS
Enrollment address
1031 Northridge Rd
Baldwyn, MS 38824-1173

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Tommy Turner Jr Individual Corporate Officer Jul 2, 2009
W-2 Managing Employee Jul 2, 2009
Anita J Turner Individual 5% Or Greater Direct Ownership Interest Aug 2, 1993
Corporate Officer Aug 2, 2003 100%
Corporate DirectorDirector Aug 12, 2013
W-2 Managing EmployeeOwner Aug 2, 1993

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Anita Joy Turner, FNP
    • Family Nurse Practitioner
    • Baldwyn, MS
    • NPI 1356335764

    5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 12

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": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512691200000",
    "number": "1497820310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 NORTHRIDGE RD",
            "city": "BALDWYN",
            "state": "MS",
            "postal_code": "388241173",
            "telephone_number": "662-365-9305",
            "fax_number": "662-365-9304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 NORTHRIDGE RD",
            "city": "BALDWYN",
            "state": "MS",
            "postal_code": "388241173",
            "telephone_number": "662-365-9305",
            "fax_number": "662-365-9304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NURSEMED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2017-12-08",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-365-9305",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MS",
            "license": "R622176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06403005",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NurseMed 2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baldwyn, MS

Sources for this page

Verify at the official NPI Registry.