Crawford Health Clinic, LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

R740067 Issued in MS

Legal business name

CRAWFORD HEALTH CLINIC, LLC

Practice address

15865 Highway 14
Macon, MS 39341

Phone

(662) 435-7800

NPI assigned

Sep 19, 2007

Last updated

Mar 8, 2012By 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. Felicia Deloris Edwards, NURSE PRACTITIONER

Title

Managing Partner

Phone

(662) 435-7800

Specialties & licenses 1

Addresses

Other identifiers 1

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Crawford Mobile Health Clinic

  • Rural Health Clinic/Center
  • Macon, MS
  • NPI 1245506377
  NPPES parent name

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331164800000",
    "number": "1912193459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95",
            "city": "CRAWFORD",
            "state": "MS",
            "postal_code": "397430095",
            "telephone_number": "662-435-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15865 HIGHWAY 14",
            "city": "MACON",
            "state": "MS",
            "postal_code": "39341",
            "telephone_number": "662-435-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAWFORD HEALTH CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2012-03-08",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "FELICIA",
        "authorized_official_middle_name": "DELORIS",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "662-435-7800",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MS",
            "license": "R740067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03825275",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Jean Brown, COTA
• Yolanda M Bush, FNP
• Patricia L Campbell, CFNP
• Beverly W Clark, FNP-C
• Marlina Conner
• Crawford Mobile Health Clinic
• Katherine Dalstra
• Roxie Joy Dickson
• Shalena Dixon
• Jennifer Yuson Dozier, NP

• Rural Health Clinic/Center in Macon, MS
• Providers in Macon, MS by specialty
• Rural Health Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.