Springridge Medical Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SPRINGRIDGE MEDICAL CLINIC

Practice address

507 Springridge Rd Ste a
Clinton, MS 39056-5628

Phone

(601) 708-1414

Fax

(601) 708-1415

NPI assigned

Oct 20, 2019

Last updated

Oct 25, 2022By 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

Dr. Shinita Reed Dudley, MDNPI 1154354603

Title

Dr.

Phone

(601) 213-7681

Specialties & licenses 1

Addresses

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/20293/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, and the practitioner matching its NPPES authorized official.

• Shinita Reed Dudley, MD

  • Family Medicine Physician
  • Clinton, MS
  • NPI 1154354603
  Authorized official Same address or phone

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

{
    "created_epoch": "1571529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1689217978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 SPRINGRIDGE RD STE A",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565628",
            "telephone_number": "601-708-1414",
            "fax_number": "601-708-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 SPRINGRIDGE RD STE A",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565628",
            "telephone_number": "601-708-1414",
            "fax_number": "601-708-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGRIDGE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-20",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A",
        "authorized_official_last_name": "DUDLEY",
        "authorized_official_first_name": "SHINITA",
        "authorized_official_middle_name": "REED",
        "authorized_official_title_or_position": "DR.",
        "authorized_official_telephone_number": "601-213-7681",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• St. Dominic Medical Associates Inc (Family Practice Associates Clinton)
• Sta-Home Health Agency of Jackson, Inc. (AccentCare Home Health of Jackson)
• Amy Elizabeth Stackler, LPC

• Family Medicine Physician in Clinton, MS
• Providers in Clinton, 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 Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.