NPIMap

Organization Active NPI

Brewer Healthcare Clinic, LLC

  • Nurse Practitioner
  • Pelahatchie, MS
National Provider Identifier
1821328360
Registry record updated Jan 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R544787 Issued in MS
Legal business name
BREWER HEALTHCARE CLINIC, LLC
Practice address
610 Hwy 80
Pelahatchie, MS 39145
Phone
(601) 854-5044
Fax
(601) 854-8448
NPI assigned
Jan 6, 2010
Last updated
Jan 6, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2010

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

Authorized official

Name
Linda BrewerNPI 1134160518
Title
Onwer
Phone
(601) 854-5044

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X R544787 MS Primary

Addresses

Primary practice location

610 Hwy 80
Pelahatchie, MS 39145

Mailing address

PO Box 445
Pelahatchie, MS 39145-0445
Phone (601) 854-5044

National Provider Directory

National Provider Directory

Locations

610 Second St
Pelahatchie, MS 39145
Phone (601) 200-4266

Practitioners & affiliated clinicians

Practitioners 1

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": "1262736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262736000000",
    "number": "1821328360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 445",
            "city": "PELAHATCHIE",
            "state": "MS",
            "postal_code": "391450445",
            "telephone_number": "601-854-5044",
            "fax_number": "601-854-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 HWY 80",
            "city": "PELAHATCHIE",
            "state": "MS",
            "postal_code": "39145",
            "telephone_number": "601-854-5044",
            "fax_number": "601-854-8448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREWER HEALTHCARE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-06",
        "last_updated": "2010-01-06",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "ONWER",
        "authorized_official_telephone_number": "601-854-5044"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R544787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pelahatchie, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; 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.