NPIMap

Organization Active NPI

Green Tree Family Medical Clinic

  • Rural Health Clinic/Center
  • Mount Olive, MS
National Provider Identifier
1770741191
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GREEN TREE FAMILY MEDICAL CLINIC
Practice address
603 Main Street
Mt. Olive, MS 39119
Phone
(601) 797-3405
Fax
(601) 797-4707
NPI assigned
Jun 2, 2008
Last updated
Jun 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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

Authorized official

Name
Ms. Kathy M Bynum
Title
Clinic Director
Phone
(601) 765-3180

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

603 Main Street
Mt. Olive, MS 39119

Mailing address

PO Box 1107
Mount Olive, MS 39119-1107
Phone (601) 797-3405

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 32

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.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212364800000",
    "number": "1770741191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1107",
            "city": "MOUNT OLIVE",
            "state": "MS",
            "postal_code": "391191107",
            "telephone_number": "601-797-3405",
            "fax_number": "601-797-3405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 MAIN STREET",
            "city": "MT. OLIVE",
            "state": "MS",
            "postal_code": "39119",
            "telephone_number": "601-797-3405",
            "fax_number": "601-797-4707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN TREE FAMILY MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-02",
        "last_updated": "2008-06-02",
        "status": "A",
        "authorized_official_last_name": "BYNUM",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "601-765-3180",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Olive, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.