NPIMap

Organization Active NPI

Family Clinic of Falkner, Inc.

  • Family Nurse Practitioner
  • Falkner, MS
National Provider Identifier
1891077137
Registry record updated Jun 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R764359 Issued in MS
Legal business name
FAMILY CLINIC OF FALKNER, INC.
Practice address
10150 CR 200
Falkner, MS 38629-0131
Phone
(662) 512-0139
Fax
(662) 512-0438
NPI assigned
Sep 13, 2011
Last updated
Jun 26, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2012

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

Authorized official

Name
Melinda L Quinn, FNP-CNPI 1750570677
Title
Nurse Practitioner
Phone
(662) 512-0139

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
Family Nurse Practitioner 363LF0000X R764359 MS Primary

Addresses

Primary practice location

10150 CR 200
Falkner, MS 38629-0131

Mailing address

P O Box 131
Falkner, MS 38629-0131
Phone (662) 512-0139

Other identifiers 1

IdentifierTypeStateIssuer
03381311MedicaidMS

National Provider Directory

National Provider Directory

Locations

10150 County Road 200
Falkner, MS 38629
Phone (662) 512-0139

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": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340668800000",
    "number": "1891077137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 131",
            "city": "FALKNER",
            "state": "MS",
            "postal_code": "386290131",
            "telephone_number": "662-512-0139",
            "fax_number": "662-512-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10150 CR 200",
            "city": "FALKNER",
            "state": "MS",
            "postal_code": "386290131",
            "telephone_number": "662-512-0139",
            "fax_number": "662-512-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CLINIC OF FALKNER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-13",
        "last_updated": "2012-06-26",
        "status": "A",
        "authorized_official_last_name": "QUINN",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "662-512-0139",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R764359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03381311",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Falkner, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; 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.