NPIMap

Organization Active NPI

Picayune Family Practice Clinic, LLC

Doing business as Picayune Family Clinic

  • Primary Care Clinic/Center
  • Picayune, MS
National Provider Identifier
1972771806
Registry record updated Feb 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PICAYUNE FAMILY PRACTICE CLINIC, LLC
Doing business as
Picayune Family Clinic
Practice address
422 Memorial Blvd
Picayune, MS 39466-5544
Phone
(601) 798-2151
Fax
(601) 798-2184
NPI assigned
Feb 13, 2008
Last updated
Feb 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2008

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

Authorized official

Name
Mrs. Amy Ali, FNP
Title
Owner
Phone
(228) 385-7715

Specialties & licenses 1

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

Addresses

Primary practice location

422 Memorial Blvd
Picayune, MS 39466-5544

Mailing address

PO Box 6913
Gulfport, MS 39506-6913
Phone (228) 385-7715

Other names 1

  • Picayune Family Clinic Doing business as

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, 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": "1202860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202860800000",
    "number": "1972771806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6913",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395066913",
            "telephone_number": "228-385-7715",
            "fax_number": "228-385-7719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 MEMORIAL BLVD",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394665544",
            "telephone_number": "601-798-2151",
            "fax_number": "601-798-2184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PICAYUNE FAMILY PRACTICE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-13",
        "last_updated": "2008-02-13",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "228-385-7715",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Picayune Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Picayune, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; 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.