Greene Rural Health Center

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

License

11343 Issued in MS

Legal business name

GREENE RURAL HEALTH CENTER

Doing business as

Greene Family Medical Clinic

Practice address

1017 Jackson Ave
Leakesville, MS 39451-9105

Phone

(601) 394-4135

Fax

(601) 394-4455

NPI assigned

Jan 23, 2008

Last updated

Jul 14, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Odessa Glynn

Title

Business Office Director

Phone

(601) 394-4135

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• GREENE FAMILY MEDICAL CLINIC Doing business as

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1992982805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 JACKSON AVE",
            "city": "LEAKESVILLE",
            "state": "MS",
            "postal_code": "394519105",
            "telephone_number": "601-394-4135",
            "fax_number": "601-394-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 JACKSON AVE",
            "city": "LEAKESVILLE",
            "state": "MS",
            "postal_code": "394519105",
            "telephone_number": "601-394-4135",
            "fax_number": "601-394-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENE RURAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-23",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "GLYNN",
        "authorized_official_first_name": "ODESSA",
        "authorized_official_title_or_position": "BUSINESS OFFICE DIRECTOR",
        "authorized_official_telephone_number": "601-394-4135",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "MS",
            "license": "11343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06200741",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02255270",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04428516",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GREENE FAMILY MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Greene County Hospital
• Greene County Hospital, Inc.
• Greene County Hospital, Inc.
• Greene County Nursing and Rehabilitation Center, Inc. (Greene Rural Health Center)
• Greene Rural Health Center
• Greene Rurual Health Center
• Kimberley Gurley, FNP-C
• Laurie Marie Hancock, COMS
• Caron Gibson Henderson, ANP
• Charlene Hicks, NP

• Community Health Clinic/Center in Leakesville, MS
• Providers in Leakesville, MS by specialty
• Community Health Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.