Organization Active NPI

Oxford Family Clinic,LLC

  • Family Nurse Practitioner
  • Oxford, MS
National Provider Identifier
1740412287
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R857620 Issued in MS
Legal business name
OXFORD FAMILY CLINIC,LLC
Practice address
1109 N Lamar Blvd
Suite 1
Oxford, MS 38655-2861
Phone
(662) 238-7860
Fax
(662) 238-7871
NPI assigned
Aug 18, 2009
Last updated
Mar 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Authorized official

Name
Michelle CullenNPI 1063645166
Title
FNP
Phone
(662) 238-7860

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R857620 MS Primary

Addresses

Primary practice location

1109 N Lamar Blvd
Suite 1
Oxford, MS 38655-2861

Mailing address

1914 University Ave
Oxford, MS 38655-4114
Phone (662) 238-7860

Other identifiers 1

IdentifierTypeStateIssuer
04105296MedicaidMS

National Provider Directory

National Provider Directory

Locations

1109 N Lamar Blvd
Oxford, MS 38655
Phone (662) 238-7860

1109 N Lamar Blvd
Ste 1
Oxford, MS 38655
Phone (662) 238-7860

1914 University Ave
Oxford, MS 38655
Phone (662) 238-7860

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615766400000",
    "number": "1740412287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1914 UNIVERSITY AVE",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386554114",
            "telephone_number": "662-238-7860",
            "fax_number": "662-238-7871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 N LAMAR BLVD",
            "address_2": "SUITE 1",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386552861",
            "telephone_number": "662-238-7860",
            "fax_number": "662-238-7871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OXFORD FAMILY CLINIC,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-18",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A",
        "authorized_official_last_name": "CULLEN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "662-238-7860"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R857620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04105296",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.