Open Arms Children'S Clinic LLC,

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

OPEN ARMS CHILDREN'S CLINIC LLC,

Practice address

809 N Jackson St Ste C
Crystal Springs, MS 39059-2177

Phone

(601) 308-5253

Fax

(601) 308-5263

NPI assigned

Dec 1, 2018

Organization subpart

No

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

Authorized official

Name

Martha McGrew, NPNPI 1962916114

Title

Owner

Phone

(601) 308-5253

Specialties & licenses 1

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

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18456/brand/1/csg/1/fhir/r4

Practitioners 1

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

• Martha McGrew

  • Family Nurse Practitioner
  • Crystal Springs, MS
  • NPI 1962916114
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1543622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543622400000",
    "number": "1689144792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 N JACKSON ST STE C",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390592177",
            "telephone_number": "601-308-5253",
            "fax_number": "601-308-5263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 N JACKSON ST STE C",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390592177",
            "telephone_number": "601-308-5253",
            "fax_number": "601-308-5263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN ARMS CHILDREN'S CLINIC LLC,",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-01",
        "last_updated": "2018-12-01",
        "status": "A",
        "authorized_official_last_name": "MCGREW",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-308-5253",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Crystal Springs, MS
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• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2018; 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.