First Choice Family Healthcare Clinic LLC

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

FIRST CHOICE FAMILY HEALTHCARE CLINIC LLC

Practice address

119 S Oak Ste 2
Raymond, MS 39154-4205

Phone

(601) 526-9001

Fax

(601) 526-9118

NPI assigned

Mar 25, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Morlyn Russell, DNP, FNP-C

Title

DNP/Coo

Phone

(601) 526-9001

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664496000000",
    "number": "1548720568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1473",
            "city": "RAYMOND",
            "state": "MS",
            "postal_code": "391541473",
            "telephone_number": "601-526-9001",
            "fax_number": "601-526-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 S OAK STE 2",
            "city": "RAYMOND",
            "state": "MS",
            "postal_code": "391544205",
            "telephone_number": "601-526-9001",
            "fax_number": "601-526-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CHOICE FAMILY HEALTHCARE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-25",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "MORLYN",
        "authorized_official_title_or_position": "DNP/COO",
        "authorized_official_telephone_number": "601-526-9001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548720568",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Raymond",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "119 S Oak Ste 2",
            "city": "Raymond",
            "state": "MS",
            "country_code": "US",
            "postal_code": "391544205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Raymond, MS
• Community Health Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.