South Rankin Family Clinic, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

12884 Issued in MS

Legal business name

SOUTH RANKIN FAMILY CLINIC, LLC

Practice address

368 Scarbrough St
Suite B
Richland, MS 39218-9038

Phone

(601) 664-2273

Fax

(601) 664-3472

NPI assigned

Nov 21, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Roderick Anthony Shields, M.D.NPI 1760436570

Title

Owner

Phone

(601) 664-2273

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IAFCAA

Practitioners 2

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.

• Roderick A Shields, MD

  • Family Medicine Physician
  • Florence, MS
  • NPI 1760436570
  Medicare reassignment NPD Authorized official
• Bradley Keith Shields

  • Nurse Practitioner
  • Florence, MS
  • NPI 1073086005
  Medicare reassignment NPD

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629143334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 SCARBROUGH ST",
            "address_2": "SUITE B",
            "city": "RICHLAND",
            "state": "MS",
            "postal_code": "392189038",
            "telephone_number": "601-664-2273",
            "fax_number": "601-664-3472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 SCARBROUGH ST",
            "address_2": "SUITE B",
            "city": "RICHLAND",
            "state": "MS",
            "postal_code": "392189038",
            "telephone_number": "601-664-2273",
            "fax_number": "601-664-3472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH RANKIN FAMILY CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHIELDS",
        "authorized_official_first_name": "RODERICK",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-664-2273",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "12884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Noel Sharp, PT
• Kendra Shell
• Steven Dewitt Shields, RPH
• Ronald Earl Skelton, RPH
• Tyler Smith
• Southern Charm Family Healthcare
• St. Joseph Hospice of West Mississippi, LLC
• Samantha Danielle Statham, NP
• Transforming Minds Therapeutic Counseling Services, LLC
• Justin Traylor, ATC

• Family Medicine Physician in Richland, MS
• Providers in Richland, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.