WINSTON MEDICAL CLINIC LLC (NPI# 1033598503) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033598503 |
| Entity Type | Organization |
| Organization Name | WINSTON MEDICAL CLINIC LLC |
| Other Organization Name | WINSTON MEDICAL CLINIC MAIN STREET |
| Practice Address |
16569 W Main St Louisville MS 39339 |
| Mailing Address |
16569 W Main St Po Box 470 Louisville MS 39339-2620 |
| Practice Telephone | 6627735704 |
| Practice Fax Number | 6627739463 |
| Mailing Telephone | 6627735704 |
| Mailing Fax Number | 6627739463 |
| Enumeration Date | 2015-05-29 |
| Last Update Date | 2018-08-09 |
| Authorized Official Name | DEBRA J FRYERY (DIRECTOR OF CLINIC OPERATIONS) |
| Authorized Official Telephone | 6624461972 |
| Is Organization Subpart | Y |
| Parent Organization Name | WINSTON MEDICAL CLINIC LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 03335534 | 05 |
| Other Name | Type Code |
|---|---|
| Winston Medical Clinic Main Street | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588091714 | Winston Medical Clinic LLC | Clinic/Center | 90 East Main Street, Noxapater, MS 39346 | 2013-10-02 |
| 1629417324 | Winston Medical Clinic LLC | Clinic/Center | 923 S Church Ave, Louisville, MS 39339 | 2013-06-17 |
| Street Address |
16569 W MAIN ST |
| City | LOUISVILLE |
| State | MS |
| Zip Code | 39339 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295378339 | Laken Nicole Fulcher | Nurse Practitioner | 16569 W Main St, Louisville, MS 39339-2647 | 2019-10-22 |
| 1902379795 | Kali Dempsey Rogers | Registered Nurse | 16569 W Main St, Louisville, MS 39339-2647 | 2019-01-04 |
| 1447733910 | Emily Jenkins Stidham | Nurse Practitioner | 16569 W Main St, Louisville, MS 39339-2647 | 2018-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972149573 | Thomas Cefalu | Pharmacist | 16575 E Main St, Louisville, MS 39339 | 2019-11-19 |
| 1720506371 | Jennifer Marie Burns | Physical Therapist | 110 N Walmart Drive Suite F, Louisville, MS 39339 | 2017-09-05 |
| 1326409335 | Courtney Nicole Shaw | Speech-Language Pathologist | 316 Rocky Hill Road, Louisville, MS 39339 | 2016-03-18 |
| 1689969735 | Adam C Byrd | Dermatology | 313 N Court Ave, Ummc Dermatology - Louisville Clinic, Louisville, MS 39339 | 2011-06-16 |
| 1356587208 | Louisville Healthcare LLC | Skilled Nursing Facility | 543 East Main Street, Louisville, MS 39339 | 2008-12-24 |
| 1699935908 | Stephen Eugene Hunter | Emergency Medicine | 100 Ellie Smith Rd, Louisville, MS 39339 | 2008-06-10 |
| 1669566279 | Southern Pharmaceutical Corporation | Durable Medical Equipment & Medical Supplies | 17220 E Main St Ste C, Louisville, MS 39339 | 2006-10-03 |
| 1184737017 | Louisville Eye Care | Optometrist | 500 North Church, Louisville, MS 39339 | 2006-08-16 |
| 1679583249 | Raymond John Orgler | Surgery | 547 E. Main St, Louisville, MS 39339 | 2006-08-08 |
| 1962484899 | Michael L. Ard | Family Medicine | 17540 E Main Street, Louisville, MS 39339 | 2005-11-16 |
| Find all providers in zip 39339 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437290798 | Family Health Clinic | Clinic/Center | 134 S. Church St., Louisville, IL 62858 | 2007-02-09 |
| 1538190624 | Attentus Eufaula, LLC | Clinic/Center | 31 Railroad St, Louisville, AL 36048-3134 | 2006-07-06 |
| 1134750243 | Trinity Health and Wellness, LLC. | Clinic/Center | 850 Bryant St, Louisville, IL 62858-1000 | 2020-01-28 |
| 1134632045 | The Health Care Authority of The City of Eufaula | Clinic/Center | 31 Railroad St, Louisville, AL 36048-3123 | 2017-11-14 |
| 1063878106 | Medical-care LLC | Clinic/Center | 809 Peachtree St, Louisville, GA 30434-1449 | 2016-01-05 |
| 1629417324 | Winston Medical Clinic LLC | Clinic/Center | 923 S Church Ave, Louisville, MS 39339 | 2013-06-17 |
| 1215943915 | Hospital Authority of Jefferson County and The City of Louisville | Clinic/Center | 1067 Peachtree St, Louisville, GA 30434-1558 | 2006-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730786120 | Ochsner Medical Center - Hancock, LLC | Clinic/Center | 2274 Highway 43 S Ste 200, Picayune, MS 39466-8141 | 2020-10-08 |
| 1306460282 | Covington County Hospital | Clinic/Center | 105 Eaton St, Taylorsville, MS 39168-5614 | 2020-06-05 |
| 1871117747 | Covington County Hospital | Clinic/Center | 1039 Highway 42 Ste C, Sumrall, MS 39482-4478 | 2020-06-05 |
| 1194365338 | Bounds Family Medical | Clinic/Center | 870 Main St Ste A, Fayette, MS 39069-5695 | 2020-01-15 |
| 1720649577 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 19 Third St, Belmont, MS 38827 | 2019-06-24 |
| 1255999611 | Boa Vida Hospital of Aberdeen, Ms LLC | Clinic/Center | 400 3rd Ave 32 West, New Houlka, MS 38850 | 2019-05-31 |
| 1598238545 | South Sunflower County Hospital | Clinic/Center | 1001 West Delta, Moorhead, MS 38761 | 2019-01-02 |
| 1790272185 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 670 Ms-178, Suite 5, Sherman, MS 38869 | 2018-04-20 |
| 1124515515 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 2200 5th St N, Columbus, MS 39705-2212 | 2018-04-20 |
| 1205323698 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 815 2nd Ave N, Columbus, MS 39701-4703 | 2018-04-20 |
| Find all providers with the same taxonomy | ||||
| City | LOUISVILLE |
| Zip Code | 39339 |
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| 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.