Family Med 101, Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

R763457 Issued in MS

Legal business name

FAMILY MED 101, INC

Practice address

101 Mimosa St
Booneville, MS 38829-2911

Phone

(662) 720-4919

Fax

(662) 720-4980

NPI assigned

Sep 27, 2006

Last updated

Nov 9, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Felesha D Perrigo, FNPNPI 1518959584

Title

Owner/Nurse Practitioner

Phone

(662) 720-4919

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

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

CLIA laboratory certificates

Locations

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.

• Felesha Dale Perrigo, FNP

  • Family Nurse Practitioner
  • Booneville, MS
  • NPI 1518959584
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510185600000",
    "number": "1902997059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388290060",
            "telephone_number": "662-720-4919",
            "fax_number": "662-720-4980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MIMOSA ST",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388292911",
            "telephone_number": "662-720-4919",
            "fax_number": "662-720-4980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MED 101, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2017-11-09",
        "status": "A",
        "authorized_official_last_name": "PERRIGO",
        "authorized_official_first_name": "FELESHA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/NURSE PRACTITIONER",
        "authorized_official_telephone_number": "662-720-4919",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MS",
            "license": "R763457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Callie A Emmons, BSW
• Encore Rehabilitation, Inc. (Encore Rehab of Booneville)
• Faith Family Clinic of Booneville
• Faith Family Clinic, LLC
• Family First Medical Clinic, LLC
• Margaret Fava, FNP
• Joseph H. Feller, MD
• Aaron Ford
• Melissa Ford, OT
• Alan Gammill, BA

• Primary Care Clinic/Center in Booneville, MS
• Providers in Booneville, MS by specialty
• Primary Care Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2017; 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.