Organization Active NPI

Total Healthcare Clinic LLC

  • Family Medicine Physician
  • Jackson, MS
National Provider Identifier
1598306920
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TOTAL HEALTHCARE CLINIC LLC
Practice address
2964 Terry Rd Ste B1
Jackson, MS 39212-3070
Phone
(601) 321-9453
Fax
(601) 398-4699
NPI assigned
Oct 7, 2019
Last updated
May 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Authorized official

Name
Marsha Lynn Austin, NPNPI 1851622120
Title
FNP
Phone
(601) 321-9453

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
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

2964 Terry Rd Ste B1
Jackson, MS 39212-3070

Mailing address

2964 Terry Rd Ste B-1
Jackson, MS 39212-3070
Phone (601) 321-9453

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL mkaustin45@gmail.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200217000448 MS Part B Supplier - Clinic/Group Practice 7810324613 Receives reassigned benefits from 1 practitioner
Practice locations: Jackson, MS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2175640Total Healthcare Clinic LLC2964 Terry Rd Ste B-1, Jackson, MS 39212Certificate of waiverNov 24, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1570406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589932800000",
    "number": "1598306920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2964 TERRY RD STE B-1",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392123070",
            "telephone_number": "601-321-9453",
            "fax_number": "601-398-4699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2964 TERRY RD STE B1",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392123070",
            "telephone_number": "601-321-9453",
            "fax_number": "601-398-4699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL HEALTHCARE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-07",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "MARSHA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "601-321-9453",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mkaustin45@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "2964 Terry Rd Ste B1",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392123070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; 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.