Independent Healthcare Management, Inc
Organization Active NPI Rural Health Clinic/Center · Forest, MS
NPI 1649761685 · NPPES record last updated May 26, 2020
Key facts
- NPI
- 1649761685
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- INDEPENDENT HEALTHCARE MANAGEMENT, INC
- Practice address
- 1 Medical LN Ste B
Forest, MS 39074-4039 - Phone
- (601) 469-4861
- NPI assigned
- May 25, 2018
- Organization subpart
- No
Authorized official
- Name
- John P Lee, MD
- Title
- Cob
- Phone
- (601) 469-4861
Other NPIs on the same Medicare enrollment 13
Member of 1
Practitioners 1
-
William Mark Lewis, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031215000487 | MS | Part B Supplier - Clinic/Group Practice | 0840197232 |
Receives reassigned benefits from 95 practitioners 13 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Raleigh, MS; Newton, MS; Morton, MS; Magee, MS; Forest, MS |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
1 Medical LN Ste B
Forest, MS 39074-4039
Mailing address
100 Pioneer Way
Magee, MS 39111-5501
Phone (601) 849-6440
Other practice location 1
1 Medical Ln
Forest, MS 39074-4039
Phone (601) 469-4861
Other names
- Forest Family Practice
Other providers in Forest, MS
- Austin Archie Howard Jr.
- Enda Huddleston
- John Richard Hunt
- Rachel Hurdle
- Independent Healthcare Management, Inc
- Independent Healthcare Management, Inc
- Independent Healthcare Management, Inc
- Independent Healthcare Management, Inc,
- Independent Healthcare Management, Inc.
- Independent Healthcare Management, Inc.
All providers in Forest, MS · Rural Health Clinic/Center in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 26, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.