Gorton Rural Health Clinic

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

GORTON RURAL HEALTH CLINIC

Practice address

107 Church St
Belzoni, MS 39038-3929

Phone

(662) 247-2105

NPI assigned

Feb 26, 2007

Last updated

May 19, 2016By 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

Sidney Carlton Gorton, MDNPI 1972572683

Title

Medical Director

Phone

(662) 247-2105

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699801654. Details of each certification follow.

• CCN 253800 Rural health clinic · Active · Details

Rural health clinic certification: CCN 253800

Legal name

GORTON RURAL HEALTH CLINIC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Aug 1, 2007

Last certification

Mar 29, 2022

Ownership / control type

1C

Organization structure

LLCProprietary

Incorporated

Jun 20, 2007 in MS

Enrollment address

107 Church St
Belzoni, MS 39038-3929

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

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Sidney Carlton Gorton, MD

  • Internal Medicine Physician
  • Belzoni, MS
  • NPI 1972572683

  5% Or Greater Direct Ownership Interest, W-2 Managing Employee

  CMS ownership

Practitioners 5

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.

• Sidney Carlton Gorton, MD

  • Internal Medicine Physician
  • Belzoni, MS
  • NPI 1972572683
  Medicare reassignment Care Compare group NPD Authorized official
• Walter M Gorton, M.D.

  • Internal Medicine Physician
  • Belzoni, MS
  • NPI 1528037116
  Medicare reassignment NPD
• Jeffrey B Hughes, PA

  • Medical Physician Assistant
  • Belzoni, MS
  • NPI 1841799616
  Care Compare group NPD (past)
• Elizabeth Nichols Lott, CFNP

  • Nurse Practitioner
  • Belzoni, MS
  • NPI 1528376894
  Care Compare group NPD (past)
• Baylee Richardson, PA-C

  • Family Medicine Physician
  • Belzoni, MS
  • NPI 1881392199
  Care Compare group NPD (past)

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463616000000",
    "number": "1699801654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 CHURCH ST",
            "city": "BELZONI",
            "state": "MS",
            "postal_code": "390383929",
            "telephone_number": "662-247-2105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 CHURCH ST",
            "city": "BELZONI",
            "state": "MS",
            "postal_code": "390383929",
            "telephone_number": "662-247-2105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORTON RURAL HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2016-05-19",
        "status": "A",
        "authorized_official_last_name": "GORTON",
        "authorized_official_first_name": "SIDNEY",
        "authorized_official_middle_name": "CARLTON",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "662-247-2105",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• G & P Pharmacy Inc (G & P Pharmacy)
• G a Carmichael Family Health Center
• G a Carmichael Family Health Center Inc
• G a Carmichael Family Health Center Inc
• Gorton Lab and X-Ray, LLC
• Sidney Carlton Gorton, MD
• Walter M Gorton, M.D.
• Payton Goss
• Grace Medical Lab LLC
• Hall Adult Senior Daycare LLC (Hall adult senior daycare)

• Rural Health Clinic/Center in Belzoni, MS
• Providers in Belzoni, MS by specialty
• Rural Health Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.