Home in the Woods Healthcare Clinic, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

HOME IN THE WOODS HEALTHCARE CLINIC, LLC

Doing business as

Home in the Woods Healthcare Clinic, LLC

Practice address

6572 County Road 514
Itta Bena, MS 38941-2746

Phone

(601) 896-1789

NPI assigned

Jun 28, 2019

Organization subpart

No

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

Authorized official

Name

Tanga Robinson, CFNP

Title

Family Nurse Practitioner

Phone

(601) 896-1789

Specialties & licenses 1

Addresses

Other names 1

• Home in the Woods Healthcare Clinic, LLC Doing business as

Locations

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

{
    "created_epoch": "1561680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576108800000",
    "number": "1720640899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6572 COUNTY ROAD 514",
            "city": "ITTA BENA",
            "state": "MS",
            "postal_code": "389412746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6572 COUNTY ROAD 514",
            "city": "ITTA BENA",
            "state": "MS",
            "postal_code": "389412746",
            "telephone_number": "601-896-1789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME IN THE WOODS HEALTHCARE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-28",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "TANGA",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "601-896-1789",
        "authorized_official_credential": "CFNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home in the Woods Healthcare Clinic, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Home in the Woods Healthcare Clinic, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Delta Life Therapeutic Solutions PLLC
• Delta Valley Development Corp
• Freds Stores of Tennessee Inc (Freds Xpress 3666)
• G a Carmichael Family Health Center, Inc.
• Greenwood Leflore Hospital (Itta Bena Clinic)
• In His Presence Daycare Ms
• Vicki Nicole Lary, CFNP
• Nathan Lewis, ATC, LAT
• Yalinda Smith Roach, FNP
• The Pharos Inc.

• Primary Care Clinic/Center in Itta Bena, MS
• Providers in Itta Bena, MS by specialty
• Primary Care Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.