Petal Urgent Care LLC
Organization Active NPI Urgent Care Clinic/Center · Petal, MS
NPI 1982908877 · NPPES record last updated Jul 21, 2026
Key facts
- NPI
- 1982908877
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urgent Care Clinic/Center 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
- Organization subpart
- No
Authorized official
- Name
- Brianne Nichole Whitney
- Title
- Coo/President
- Phone
- (707) 319-5068
Practitioners 40
-
Steffany Bedwell, NP
-
Kelly Day, N.P.
-
Angela Denise Haigler, NP-C
-
Joanna R McCollum, CFNP
-
Kelsa Shirley, FNP
-
Geraldine Q Young, CFNP
-
Lisa Graham Blesse, FNP
-
Sheree Conley-Donaldson, PHD, DNP, FNP, PMHNP
-
Michael W Fairbanks, FNP
-
Shelia Gann, NURSE PRACTITIONER-C
-
Jonathan Adam Giangrosso, FNP-BC
-
William Bryan Gibboney, DNP, FNP-C, ACNP-BC
-
Heather H Hager, NP
-
Cynthia Harrington, FNP
-
Lane Lloyd Hartt, MD
-
Selena M Powe, FNP
-
Tyrone Leavette Rupert, N.P.
-
Damon Scott Spears, RN,MSN, FNP-C
-
Lesia Thomas, FNP-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 25D2019409 | Petal Urgent Care Clinic | Certificate of waiver | Jan 27, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110404000578 | MS | Part B Supplier - Clinic/Group Practice | 9133303811 |
Receives reassigned benefits from 38 practitioners Practice locations: Petal, MS |
National Provider Directory
Locations
4910 Old Highway 11
Hattiesburg, MS 39402
Phone (228) 424-0806
300 N Frontage Rd
Ste 700
Meridian, MS 39301
Phone (601) 336-5393
1272 Evelyn Gandy Pkwy
Ste 60
Petal, MS 39465
Phone (601) 336-5393
1272 Evelyn Gandy Pkwy
Petal, MS 39465
105 Highway 12 W
Starkville, MS 39759
Phone (601) 336-5393
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03704755 | Medicaid | MS |
Other providers in Petal, MS
- Petal School Clinic
- Petal School District
- Petal School District
- Petal School District
- Petal Upper Elementary School
- Pine Belt Dermatology and Skin Cancer Center
- Pine Belt Dermatopathology Lab, PA
- Pioneer Medical Portable Xray,LLC
- Pioneer Medical, LLC
- Hope V Pittman
All providers in Petal, MS · Urgent Care Clinic/Center in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.