Active NPI
Express Care of Cleveland, LLC
- Urgent Care Clinic/Center
- Cleveland, MS
National Provider Identifier
1780151381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urgent Care Clinic/Center
- Legal business name
- EXPRESS CARE OF CLEVELAND, LLC
- Practice address
- 609 N Davis Ave Ste 105
Cleveland, MS 38732-2379 - Phone
- (662) 579-3958
- Fax
- (866) 962-6149
- NPI assigned
- Nov 1, 2018
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Gregory Gowen
- Title
- Manager
- Phone
- (662) 579-3958
Practitioners 30
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 25D2162489 | Express Care of Cleveland LLC | Compliance | Oct 15, 2027 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190429000343 | MS | Part B Supplier - Clinic/Group Practice | 0547502387 |
Receives reassigned benefits from 27 practitioners Practice locations: Booneville, MS; Tupelo, MS; Starkville, MS; Cleveland, MS; Oxford, MS |
National Provider Directory
National Provider DirectoryLocations
1115 N 2nd St
Ste 1
Booneville, MS 38829
Phone (662) 480-4141
1115 N 2nd St
Booneville, MS 38829
Phone (662) 480-4141
609 N Davis Ave
Cleveland, MS 38732
Phone (662) 816-8999
609 N Davis Ave
Ste 105
Cleveland, MS 38732
Phone (662) 579-3958
1515 University Ave
Oxford, MS 38655
Phone (662) 238-0011
31 Highway 328
Oxford, MS 38655
606 Highway 12 E
Starkville, MS 39759
Phone (662) 384-8080
3558A W Main St
Tupelo, MS 38801
Phone (662) 346-8091
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
609 N Davis Ave Ste 105
Cleveland, MS 38732-2379
Mailing address
31 County Road 328
Oxford, MS 38655
Phone (662) 816-8999
Other practice location 1
606 Hwy 12 East
Starkville, MS 39759
Phone (662) 384-8080
Other practice location 2
3558-A West Main Street
Tupelo, MS 38801
Phone (662) 346-8091
Other practice location 3
1115 N 2nd St Ste 1
Booneville, MS 38829-1021
Phone (662) 480-4141
Other practice location 4
1515 University Ave
Oxford, MS 38655-4033
Phone (662) 238-0011
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09707705 | Medicaid | MS |
Electronic endpoints 1
NPPES NPI Registry| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | info@expresscareclinic.com | Direct |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 14, 2023.
{
"created_epoch": "1541030400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1686700800000",
"number": "1780151381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 COUNTY ROAD 328",
"city": "OXFORD",
"state": "MS",
"postal_code": "38655",
"telephone_number": "662-816-8999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "609 N DAVIS AVE STE 105",
"city": "CLEVELAND",
"state": "MS",
"postal_code": "387322379",
"telephone_number": "662-579-3958",
"fax_number": "866-962-6149"
}
],
"practiceLocations": [
{
"address_1": "606 Hwy 12 East",
"address_purpose": "LOCATION",
"city": "Starkville",
"state": "MS",
"postal_code": "39759",
"country_code": "US",
"telephone_number": "662-384-8080",
"fax_number": "662-269-4456",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3558-A West Main Street",
"address_purpose": "LOCATION",
"city": "Tupelo",
"state": "MS",
"postal_code": "38801",
"country_code": "US",
"telephone_number": "662-346-8091",
"fax_number": "662-499-6151",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1115 N 2nd St Ste 1",
"address_purpose": "LOCATION",
"city": "Booneville",
"state": "MS",
"postal_code": "388291021",
"country_code": "US",
"telephone_number": "662-480-4141",
"fax_number": "662-796-5275",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1515 University Ave",
"address_purpose": "LOCATION",
"city": "Oxford",
"state": "MS",
"postal_code": "386554033",
"country_code": "US",
"telephone_number": "662-238-0011",
"fax_number": "662-796-5288",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "EXPRESS CARE OF CLEVELAND, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-11-01",
"last_updated": "2023-06-14",
"certification_date": "2023-06-05",
"status": "A",
"authorized_official_last_name": "GOWEN",
"authorized_official_first_name": "GREGORY",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "662-579-3958"
},
"taxonomies": [
{
"code": "261QU0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Urgent Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "09707705",
"state": "MS"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "info@expresscareclinic.com",
"affiliation": "N",
"endpointDescription": "Info",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "609 N Davis Ave Ste 105",
"city": "Cleveland",
"state": "MS",
"country_code": "US",
"postal_code": "387322379",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Cleveland, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.