MALLORY COMMUNITY HEALTH


Address: 276 Nissan Parkway, Building C, Suite 100, Canton, MS 39046
Phone: 6018555275

MALLORY COMMUNITY HEALTH (NPI# 1013034636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1013034636
Entity Type Organization
Organization Name MALLORY COMMUNITY HEALTH
Other Organization Name DR. ARENIA C. MALLORY COMMUNITY HEALTH CENTER, INC.
Practice Address 276 Nissan Parkway, Building C
Suite 100
Canton
MS 39046
Mailing Address Po Box 479
Lexington
MS 39095-0479
Practice Telephone 6018555275
Practice Fax Number 6018593253
Mailing Telephone 6628341857
Mailing Fax Number 6628344937
Enumeration Date 2007-03-26
Last Update Date 2016-07-21
Authorized Official Name MR. CLYDE ROZELL CHAPMAN II (CHIEF EXECUTIVE OFFICER)
Authorized Official Telephone 6628341857
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QF0400X Clinic/Center
Specialization: Federally Qualified Health Center (FQHC)
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
MS 09015635 05

Other Provider/Organization Names

Other Name Type Code
Dr. Arenia C. Mallory Community Health Center, Inc. Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1104348606 Mallory Community Health Clinic/Center 9479 Brozville Rd, Lexington, MS 39095-7090 2017-07-17
1295282358 Mallory Community Health Clinic/Center 9749 Brozville Road, Lexington, MS 39095 2016-09-07
1477009876 Mallory Community Health Clinic/Center 14494 Highway 51, Durant, MS 39063-9627 2016-08-27
1427504943 Mallory Community Health Clinic/Center 12572 Highway 12, Lexington, MS 39095-8036 2016-08-26
1104279355 Mallory Community Health Clinic/Center 3877 Highway 51, Goodman, MS 39079-9588 2016-07-22
1740624881 Mallory Community Health Clinic/Center 300 Yazoo Street, Lexington, MS 39095 2013-04-19
1053649749 Mallory Community Health Clinic/Center 201 East Washington Street, Greenwood, MS 38930 2009-11-18
1053439133 Mallory Community Health Clinic/Center 201a Magnolia St, Vaiden, MS 39176-5644 2007-03-27
1881713519 Mallory Community Health Clinic/Center 9715 Highway 12 W, Tchula, MS 39169 2007-03-27
1902923527 Mallory Community Health Clinic/Center 33795 Highway 12 East, Durant, MS 39063 2007-03-26

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities MALLORY COMMUNITY HEALTH CENTER 17280 Highway 17 South, Lexington, MS 39095-6614

Office Location

Street Address 276 NISSAN PARKWAY, BUILDING C
SUITE 100
City CANTON
State MS
Zip Code 39046

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1043858053 Pediatric Haven Skilled Nursing Facility 112 Westfalen Drive, Canton, MS 39046 2019-12-20
1932743176 Stacey Elizabeth Aldridge Social Worker 210 E Peace Street, Canton, MS 39046 2019-10-31
1881245736 Mildred Loving Technician 323 Shady Lane, Canton, MS 39046 2019-09-23
1295384683 Betty Bass Technician 693 Miggins Road, Canton, MS 39046 2019-09-09
1972081644 Charles Brayden Jones Physical Therapist 276 Nissan Pkwy Ste 400, Canton, MS 39046 2018-08-03
1013436062 Andrew J Breland Counselor 210 E Peace St, Canton, MS 39046 2017-09-11
1801318290 Mississippi Enjoy Breastfeeding Shalom Resource Center Clinic/Center 343 Smith Street, Canton, MS 39046 2017-07-07
1619362977 Shameca Hudson Nurse Practitioner 274 Cobbville Dr E, Canton, MS 39046 2015-04-03
1144644386 Margaret Reimers Beckwith Chiropractor 124 Links Drive, I-103, Canton, MS 39046 2014-02-07
1053753194 Tanya Linette Calhoun Nurse Practitioner 1171 Hart Street, Canton, MS 39046 2013-07-17
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Taxonomy Information

Taxonomy Code 261QF0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Federally Qualified Health Center (FQHC)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1619319043 Richard D Watkins Canton Community Clinic, Inc Clinic/Center 3015 Mahoning Rd Ne, Canton, OH 44705-3335 2013-07-26
1063419422 Georgia Highlands Medical Services, Inc. Clinic/Center 220 Oakside Ln, Canton, GA 30114-6413 2005-06-30
1811501455 Georgia Highlands Medical Services, Inc Clinic/Center 210 Oakside Ln, Canton, GA 30114-6417 2020-09-01
1013569847 G A Carmichael Family Health Center, Inc. Clinic/Center 1668 W Peace St, Canton, MS 39046-5332 2019-07-11
1427593409 Great Salt Plains Health Center Clinic/Center 310 E. Walnut Street, Canton, OK 73724 2016-12-29
1851592034 Lifecare Family Health and Dental Center, Inc Clinic/Center 408 9th St Sw, Canton, OH 44707-4714 2007-05-29
1720289903 Richard D Watkins Canton Community Clinic, Inc. Clinic/Center 2725 Lincoln St E, Canton, OH 44707-2769 2007-05-29
1801952809 G A Carmichael Family Health Center Inc Clinic/Center 1668 West Peace Street, Canton, MS 39046 2006-12-28
1013964923 Lifecare Family Health and Dental Center, Inc Clinic/Center 2725 Lincoln St E, Canton, OH 44707-2769 2006-05-27

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1871193722 Coastal Family Health Center, Inc Clinic/Center 12424 Highway 57, Vancleave, MS 39565-8608 2020-10-29
1992305445 Coastal Family Health Center, Inc Clinic/Center 5500 Hurley Wade Rd, Moss Point, MS 39562-8548 2020-10-26
1841890399 Coastal Family Health Center, Inc Clinic/Center 10700 Yellow Jacket Rd, Ocean Springs, MS 39564-8038 2020-10-26
1033755343 Access Family Health Services, Inc. Clinic/Center 179 Mullen Ave, Nettleton, MS 38858-6033 2019-11-21
1285280180 Delta Health Center, Inc Clinic/Center 506 Washington Avenue, Moorhead, MS 38761 2019-08-15
1265088421 Delta Health Center, Inc Clinic/Center 400 South Blvd, Drew, MS 38737-3508 2019-08-14
1215583356 Delta Health Center, Inc. Clinic/Center 302 College Ave, Indianola, MS 38751-2112 2019-08-14
1063068252 Delta Health Center, Inc Clinic/Center 1101 Oak St, Inverness, MS 38753-8725 2019-08-13
1750937959 Delta Health Center, Inc Clinic/Center 212 E Claiborne St, Sunflower, MS 38778-9640 2019-08-13
1750937108 Delta Health Center, Inc Clinic/Center 410 L F Packer Dr, Ruleville, MS 38771-3604 2019-08-12
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Competitor

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City CANTON
Zip Code 39046

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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