NPIMap

Organization Active NPI

Petal Urgent Care LLC

  • Urgent Care Clinic/Center
  • Petal, MS
National Provider Identifier
1982908877
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PETAL URGENT CARE LLC
Practice address
1272 Evelyn Gandy Pkwy Ste 60
Petal, MS 39465-3953
Phone
(707) 319-5068
Fax
(601) 602-4681
NPI assigned
Jan 6, 2011
Last updated
Jul 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Authorized official

Name
Brianne Nichole Whitney
Title
Coo/President
Phone
(707) 319-5068

Specialties & licenses 1

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

Addresses

Primary practice location

1272 Evelyn Gandy Pkwy Ste 60
Petal, MS 39465-3953

Mailing address

PO Box 1248
Ocean Springs, MS 39566-1248
Phone (601) 336-5393

Other practice location 1

4910 Old Highway 11
Hattiesburg, MS 39402-9767
Phone (601) 336-5393

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110404000578 MS Part B Supplier - Clinic/Group Practice 9133303811 Receives reassigned benefits from 38 practitioners
Practice locations: Petal, 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
25D2019409Petal Urgent Care Clinic1272 Evelyn Gandy Parkway Ste 60, Petal, MS 39465Certificate of waiverJan 27, 2027

National Provider Directory

National Provider Directory

Locations

1272 Evelyn Gandy Pkwy
Petal, MS 39465

1272 Evelyn Gandy Pkwy
Ste 60
Petal, MS 39465
Phone (601) 336-5393

105 Highway 12 W
Starkville, MS 39759
Phone (601) 336-5393

Practitioners & affiliated clinicians

Practitioners 40

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 40

NPI Registry JSON

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

{
    "created_epoch": "1294272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784592000000",
    "number": "1982908877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1248",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395661248",
            "telephone_number": "601-336-5393",
            "fax_number": "601-602-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1272 EVELYN GANDY PKWY STE 60",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "394653953",
            "telephone_number": "707-319-5068",
            "fax_number": "601-602-4681"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4910 Old Highway 11",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394029767",
            "country_code": "US",
            "telephone_number": "601-336-5393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PETAL URGENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-06",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A",
        "authorized_official_last_name": "WHITNEY",
        "authorized_official_first_name": "BRIANNE",
        "authorized_official_middle_name": "NICHOLE",
        "authorized_official_title_or_position": "COO/PRESIDENT",
        "authorized_official_telephone_number": "707-319-5068"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petal, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; 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.