Organization Active NPI

Picayune Urgent Care Clinic, LLC

  • Urgent Care Clinic/Center
  • Picayune, MS
National Provider Identifier
1780723502
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PICAYUNE URGENT CARE CLINIC, LLC
Practice address
422 Memorial Blvd
Picayune, MS 39466-5544
Phone
(601) 798-2151
Fax
(601) 798-2184
NPI assigned
Feb 6, 2007
Last updated
Sep 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Authorized official

Name
Brianne Whitney
Title
Coo
Phone
(707) 319-5068

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

422 Memorial Blvd
Picayune, MS 39466-5544

Mailing address

422 Memorial Blvd
Picayune, MS 39466-5544
Phone (601) 798-2151

Other identifiers 1

IdentifierTypeStateIssuer
09921516MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070629000243 MS Part B Supplier - Clinic/Group Practice 3072612175 Receives reassigned benefits from 38 practitioners
Practice locations: Picayune, MS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D1065676Picayune Urgent Care Clinic422 Memorial Blvd, Picayune, MS 39466Certificate of waiverMay 15, 2027

National Provider Directory

National Provider Directory

Locations

801 Highway 11 S
Ste A
Picayune, MS 39466
Phone (601) 798-2151

Practitioners & affiliated clinicians

Practitioners 38

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 38

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759104000000",
    "number": "1780723502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 MEMORIAL BLVD",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394665544",
            "telephone_number": "601-798-2151",
            "fax_number": "601-798-2184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 MEMORIAL BLVD",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394665544",
            "telephone_number": "601-798-2151",
            "fax_number": "601-798-2184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PICAYUNE URGENT CARE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A",
        "authorized_official_last_name": "WHITNEY",
        "authorized_official_first_name": "BRIANNE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "707-319-5068"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09921516",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Picayune, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; 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.

Verify at the official NPI Registry.