NPIMap

Organization Active NPI

Clay County Medical Corporation

  • Land Ambulance
  • West Point, MS
National Provider Identifier
1992812291
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
13-312 Issued in MS
Legal business name
CLAY COUNTY MEDICAL CORPORATION
Practice address
835 Medical Center Dr
West Point, MS 39773-9320
Phone
(662) 495-2128
Fax
(662) 495-2361
NPI assigned
Aug 23, 2006
Organization subpart
Yes
Parent organization
CLAY COUNTY MEDICAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Authorized official

Name
Mr. Lynn Holland
Title
Vice President - Finance
Phone
(662) 377-3978

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 13-312 MS Primary

Addresses

Primary practice location

835 Medical Center Dr
West Point, MS 39773-9320

Mailing address

835 Medical Center Dr
West Point, MS 39773-9320
Phone (662) 495-2128

Other identifiers 1

IdentifierTypeStateIssuer
0553965MedicaidMS

Other names 1

  • Clay County Med Ctr - Ambulance Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Clay Cty Med Corp18 organizations share this tax ID, including this one
Part of
Clay Cty Med Corp

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184112000000",
    "number": "1992812291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 MEDICAL CENTER DR",
            "city": "WEST POINT",
            "state": "MS",
            "postal_code": "397739320",
            "telephone_number": "662-495-2128",
            "fax_number": "662-495-2361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 MEDICAL CENTER DR",
            "city": "WEST POINT",
            "state": "MS",
            "postal_code": "397739320",
            "telephone_number": "662-495-2128",
            "fax_number": "662-495-2361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAY COUNTY MEDICAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLAY COUNTY MEDICAL CORPORATION",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-07-11",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "VICE PRESIDENT - FINANCE",
        "authorized_official_telephone_number": "662-377-3978",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MS",
            "license": "13-312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0553965",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clay County Med Ctr - Ambulance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Point, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; 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.