NPIMap

Organization Active NPI

North Mississippi Clinics, LLC

Doing business as The Clinic at Walmart Oxford

  • Family Nurse Practitioner
  • Oxford, MS
National Provider Identifier
1518243443
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
NORTH MISSISSIPPI CLINICS, LLC
Doing business as
The Clinic at Walmart Oxford
Practice address
2530 Jackson Ave W
Oxford, MS 38655-5403
Phone
(662) 513-6682
Fax
(662) 513-6684
NPI assigned
Oct 24, 2011
Last updated
Feb 6, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH MISSISSIPPI CLINICS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Authorized official

Name
Gerald Kimbrough
Title
Director
Phone
(662) 377-4685

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X Primary

Addresses

Primary practice location

2530 Jackson Ave W
Oxford, MS 38655-5403

Mailing address

2530 Jackson Ave W
Oxford, MS 38655-5403
Phone (662) 513-6682

Other identifiers 1

IdentifierTypeStateIssuer
302G086375OtherMSMEDICARE GROUP

Other names 1

  • The Clinic at Walmart Oxford Doing business as

National Provider Directory

National Provider Directory
Tax ID family
N Mississippi Clinic LLC8 organizations share this tax ID, including this one
Part of
N Mississippi Clinic LLC

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1319414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675641600000",
    "number": "1518243443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 JACKSON AVE W",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555403",
            "telephone_number": "662-513-6682",
            "fax_number": "662-513-6684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 JACKSON AVE W",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555403",
            "telephone_number": "662-513-6682",
            "fax_number": "662-513-6684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH MISSISSIPPI CLINICS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH MISSISSIPPI CLINICS, LLC",
        "enumeration_date": "2011-10-24",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A",
        "authorized_official_last_name": "KIMBROUGH",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "662-377-4685"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "302G086375",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Clinic at Walmart Oxford",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Clinic at Walmart Oxford",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oxford, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.