Lucedale Family Medical Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LUCEDALE FAMILY MEDICAL CLINIC

Practice address

223 Winter St Ste D
Lucedale, MS 39452-6078

Phone

(601) 791-5012

Fax

(601) 791-5013

NPI assigned

Mar 29, 2023

Organization subpart

No

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

Authorized official

Name

Bridgot Peters

Title

Billing Director

Phone

(251) 445-7618

Specialties & licenses 1

Addresses

Other names 1

• Lucedale Family Medical Clinic, LLC Other name

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 3

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

• Norman M Parnell, CFNP

  • Family Nurse Practitioner
  • Lucedale, MS
  • NPI 1184961054
  Medicare reassignment Care Compare group NPD
• Michael Ann Parnell, NP

  • Nurse Practitioner
  • Mobile, AL
  • NPI 1750954327

  MS

  Medicare reassignment Care Compare group NPD
• Gregory R Myrick, M.D.

  • Family Medicine Physician
  • Millry, AL
  • NPI 1972786960
  NPD (past)

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715299200000",
    "number": "1992409262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6577 CREEL RD",
            "city": "THEODORE",
            "state": "AL",
            "postal_code": "365823857",
            "telephone_number": "251-725-8455",
            "fax_number": "251-445-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 WINTER ST STE D",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "394526078",
            "telephone_number": "601-791-5012",
            "fax_number": "601-791-5013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCEDALE FAMILY MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-29",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "BRIDGOT",
        "authorized_official_title_or_position": "BILLING DIRECTOR",
        "authorized_official_telephone_number": "251-445-7618"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lucedale Family Medical Clinic, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Linda Le, RPH
• Legacy Care Coaches Agency by Cpwar
• Reese G Lindsey, DO
• Lucedale Chiropractic Clinic, P.a.
• Lucedale Chiropractic LLC
• Lucedale Intermediate School
• Lucedale OB/GYN Center
• Lucedale OBGYN Center
• Lucedale Urgent Care, PC
• Tara S. Mallett, D.O.

• Family Medicine Physician in Lucedale, MS
• Providers in Lucedale, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; 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.