NPIMap

Organization Active NPI

Methodist Healthcare Community Care Associates

Doing business as Methodist Minor Medical Olive Branch

  • Urgent Care Clinic/Center
  • Olive Branch, MS
National Provider Identifier
1821272501
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
METHODIST HEALTHCARE COMMUNITY CARE ASSOCIATES
Doing business as
Methodist Minor Medical Olive Branch
Practice address
7235 Hacks Cross Rd
Olive Branch, MS 38654-4213
Phone
(662) 893-9800
Fax
(662) 893-9827
NPI assigned
Dec 18, 2007
Last updated
Feb 19, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
METHODIST LEBONHEUR HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Authorized official

Name
Eugene Cashman
Title
VP & Ceo Affiliated Services
Phone
(901) 516-1434

Specialties & licenses 1

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

Addresses

Primary practice location

7235 Hacks Cross Rd
Olive Branch, MS 38654-4213

Mailing address

PO Box 1000 Dept 38
Memphis, TN 38148-0001
Phone (901) 516-1489

Other names 1

  • Methodist Minor Medical Olive Branch Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040211000592 MS Part B Supplier - Clinic/Group Practice 0941113757 Receives reassigned benefits from 24 practitioners
Practice locations: Olive Branch, MS

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Methodist Health Sleep D5 organizations share this tax ID, including this one
Part of
Methodist Hospital Cent

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

11273 Highway 61 N
Robinsonville, MS 38664
Phone (662) 357-0012

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708300800000",
    "number": "1821272501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000 DEPT 38",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381480001",
            "telephone_number": "901-516-1489",
            "fax_number": "901-380-8081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7235 HACKS CROSS RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386544213",
            "telephone_number": "662-893-9800",
            "fax_number": "662-893-9827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST HEALTHCARE COMMUNITY CARE ASSOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "METHODIST LEBONHEUR HEALTHCARE",
        "enumeration_date": "2007-12-18",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A",
        "authorized_official_last_name": "CASHMAN",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "VP & CEO AFFILIATED SERVICES",
        "authorized_official_telephone_number": "901-516-1434"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Methodist Minor Medical Olive Branch",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Methodist Minor Medical Olive Branch",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Olive Branch, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.