NPIMap

Organization Active NPI

S&M Medical Clinic

  • Primary Care Clinic/Center
  • Durant, MS
National Provider Identifier
1912433459
Registry record updated May 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
S&M MEDICAL CLINIC
Practice address
403 Northwest Depot Street
Durant, MS 39063
Phone
(662) 633-9633
NPI assigned
May 3, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2017

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

Authorized official

Name
Latonya Smith, BA DEGREE
Title
Owner
Phone
(662) 633-9633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X MS Primary

Addresses

Primary practice location

403 Northwest Depot Street
Durant, MS 39063

Mailing address

57 Bailey St
Durant, MS 39063
Phone (662) 633-9633

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170808000725 MS Part B Supplier - Clinic/Group Practice 4880965938 Receives reassigned benefits from 3 practitioners
Practice locations: Durant, MS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493769600000",
    "number": "1912433459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 BAILEY ST",
            "city": "DURANT",
            "state": "MS",
            "postal_code": "39063",
            "telephone_number": "662-633-9633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 NORTHWEST DEPOT STREET",
            "city": "DURANT",
            "state": "MS",
            "postal_code": "39063",
            "telephone_number": "662-633-9633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S&M MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-03",
        "last_updated": "2017-05-03",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "LATONYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-633-9633",
        "authorized_official_credential": "BA DEGREE"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durant, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2017; 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.