Holly Springs Family Medical LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

HOLLY SPRINGS FAMILY MEDICAL LLC

Practice address

130 W Van Dorn Ave
Holly Springs, MS 38635-2902

Phone

(662) 274-3212

Fax

(662) 274-3213

NPI assigned

Jul 17, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Jerry D Williams II, DNP, FNP-CNPI 1073035168

Title

Owner

Phone

(662) 274-3212

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

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 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jerry D Williams II, FNP-C

  • Family Nurse Practitioner
  • Holly Springs, MS
  • NPI 1073035168
  Medicare reassignment Care Compare group NPD Authorized official
• Brittney Boyd, DNP, FNP-C

  • Family Nurse Practitioner
  • Byhalia, MS
  • NPI 1144741059
  Medicare reassignment Care Compare group NPD
• Tracy A Scott, FNP-C

  • Nurse Practitioner
  • Byhalia, MS
  • NPI 1760921696

  Family

  NPD

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

{
    "created_epoch": "1658016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661990400000",
    "number": "1518692342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 W VAN DORN AVE",
            "city": "HOLLY SPRINGS",
            "state": "MS",
            "postal_code": "386352902",
            "telephone_number": "662-274-3212",
            "fax_number": "662-274-3213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W VAN DORN AVE",
            "city": "HOLLY SPRINGS",
            "state": "MS",
            "postal_code": "386352902",
            "telephone_number": "662-274-3212",
            "fax_number": "662-274-3213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLY SPRINGS FAMILY MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-17",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-274-3212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DNP, FNP-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Healthstat on-Site Parker Hannifan Holly Springs
• Heartland Family Medical
• Glenda J Hendrix-Rayfield, NP
• Doris Marie Hervey, LMSW
• Holly Springs Eyecare PLLC (Magnolia Eye Group)
• Holly Springs Rehabilitation and Healthcare Center, LLC
• Holly Springs School District
• Sabrina Marie Hudson
• Shantanika Hunt
• I.V. Care, Inc.

• Family Nurse Practitioner in Holly Springs, MS
• Providers in Holly Springs, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.