NPIMap

Organization Active NPI

State Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Starkville, MS
National Provider Identifier
1932587706
Registry record updated Oct 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
STATE URGENT CARE, LLC
Practice address
521 S Montgomery St Ste 1
Starkville, MS 39759-3337
Phone
(662) 338-4826
Fax
(662) 268-8052
NPI assigned
May 13, 2015
Last updated
Oct 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2019

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

Authorized official

Name
Mr. Brennan D Uter
Title
Ceo / Owner
Phone
(225) 706-3033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

521 S Montgomery St Ste 1
Starkville, MS 39759-3337

Mailing address

521 S Montgomery St Ste 1
Starkville, MS 39759-3337
Phone (662) 338-4826

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150806012177 MS Part B Supplier - Clinic/Group Practice 1557675311 Receives reassigned benefits from 14 practitioners
Practice locations: Starkville, MS

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2099154State Urgent Care LLC521 S Montgomery Street, Suite 1, Starkville, MS 39759ComplianceMar 5, 2027

National Provider Directory

National Provider Directory

Locations

521 S Montgomery St
Starkville, MS 39759
Phone (662) 338-4826

521 S Montgomery St
#1
Starkville, MS 39759
Phone (662) 338-4826

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11573/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1431475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570838400000",
    "number": "1932587706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 S MONTGOMERY ST STE 1",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397593337",
            "telephone_number": "662-338-4826",
            "fax_number": "662-268-8052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 S MONTGOMERY ST STE 1",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397593337",
            "telephone_number": "662-338-4826",
            "fax_number": "662-268-8052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE URGENT CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-13",
        "last_updated": "2019-10-12",
        "status": "A",
        "authorized_official_last_name": "UTER",
        "authorized_official_first_name": "BRENNAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO / OWNER",
        "authorized_official_telephone_number": "225-706-3033",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Starkville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2019; 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.