KILMICHAEL CLINIC (NPI# 1144362054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144362054 |
| Entity Type | Organization |
| Organization Name | KILMICHAEL CLINIC |
| Other Organization Name | KILMICHAEL HOSPITAL KILMICHAEL CLINIC |
| Practice Address |
303 Lamar Avenue Kilmichael MS 39747 |
| Mailing Address |
303 Lamar Avenue P.o. Box 186 Kilmichael MS 39747 |
| Practice Telephone | 6622624284 |
| Mailing Telephone | 6622624284 |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2008-05-13 |
| Authorized Official Name | MR. CALVIN DEXTER JOHNSON SR. (ADMINISTRATOR) |
| Authorized Official Telephone | 6622624311 |
| Authorized Official Credential | MHA |
| Is Organization Subpart | N |
| 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 | 02621525 | 05 |
| Other Name | Type Code |
|---|---|
| Kilmichael Hospital Kilmichael Clinic | Other Name - Individual/Organization |
| Street Address |
303 LAMAR AVENUE |
| City | KILMICHAEL |
| State | MS |
| Zip Code | 39747 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912382060 | Webster Health Services, Inc. | Clinic/Center | 301 Lamar Street, Kilmichael, MS 39747 | 2015-07-29 |
| 1487863692 | Kilmichael Hospital | Medicare Defined Swing Bed Unit | 301 Lamar Ave, Kilmichael, MS 39747 | 2007-05-22 |
| 1124088299 | Greenwood Leflore Hospital | Clinic/Center | 400 Lamar Ave, Kilmichael, MS 39747 | 2006-03-24 |
| 1114445764 | Leslie B Pearson | Nurse Practitioner | 400 Lamar Ave, Kilmichael, MS 39747 | 2017-09-05 |
| 1518176445 | Kilmichael Hospital | Family Medicine | 301 Lamar Ave., Kilmichael, MS 39747-0188 | 2007-05-21 |
| 1144204561 | Kilmichael Hospital | General Acute Care Hospital | 301 Lamar Avenue, Kilmichael, MS 39747-0188 | 2005-11-30 |
| 1790216091 | Lajoyce Stewart | Nurse Practitioner | 301 Lamar St, Kilmichael, MS 39747-9002 | 2017-03-27 |
| 1942258322 | Cherryl M Avent | Emergency Medicine | 303 Lamar St, Kilmichael, MS 39747-9002 | 2006-05-05 |
| 1942724349 | Wade Henson | Nurse Practitioner | 301 Lamar St, Kilmichael, MS 39747-9002 | 2017-07-28 |
| 1932609674 | Rachel Montgomery | Occupational Therapy Assistant | 5 Vaiden Kilmichael Rd, Kilmichael, MS 39747-9518 | 2018-02-20 |
| Find all providers in zip 39747 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912382060 | Webster Health Services, Inc. | Clinic/Center | 301 Lamar Street, Kilmichael, MS 39747 | 2015-07-29 |
| 1124088299 | Greenwood Leflore Hospital | Clinic/Center | 400 Lamar Ave, Kilmichael, MS 39747 | 2006-03-24 |
| 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 | KILMICHAEL |
| Zip Code | 39747 |
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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.