PSP MEDICAL CLINIC, LLC (NPI# 1225320708) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225320708 |
| Entity Type | Organization |
| Organization Name | PSP MEDICAL CLINIC, LLC |
| Other Organization Name | YAZOO FAMILY CLINIC |
| Practice Address |
1435 Grand Ave Yazoo City MS 39194 |
| Mailing Address |
Po Box 607 Canton MS 39046 |
| Practice Telephone | 6627463555 |
| Practice Fax Number | 6627465211 |
| Mailing Telephone | 6018599888 |
| Mailing Fax Number | 6018599966 |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2020-10-29 |
| Authorized Official Name | DR. PARVESH K. GOEL (MD) |
| Authorized Official Telephone | 6018599888 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | PSP MEDICAL CLINIC, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
15405 | MS | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 02679823 | 05 |
| Other Name | Type Code |
|---|---|
| Yazoo Family Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033435680 | Psp Medical Clinic, LLC | Clinic/Center | 1171 Hart St., Canton, MS 39046 | 2010-04-07 |
| 1245581370 | Psp Medical Clinic, LLC | Clinic/Center | 1082 Gluckstadt Rd, Madison, MS 39110 | 2012-09-28 |
| Street Address |
1435 GRAND AVE |
| City | YAZOO CITY |
| State | MS |
| Zip Code | 39194 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245341916 | Arbie Burton Hinton | Internal Medicine | 1435 Grand Ave, Yazoo City, MS 39194-2651 | 2006-08-31 |
| 1093326118 | Legacy Counseling Services, LLC | Community/Behavioral Health | 1435 Grand Ave, Yazoo City, MS 39194-2651 | 2020-08-12 |
| 1144518515 | Lajuana Yevette Newton | Nurse Practitioner | 1435 Grand Ave, Yazoo City, MS 39194-2651 | 2011-07-19 |
| 1417131996 | Ouida Parks | Counselor | 1435 Grand Ave, Yazoo City, MS 39194-2651 | 2007-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023584703 | Aslean Brown | Home Health | 522 Old Benton Rd, Yazoo City, MS 39194 | 2018-10-19 |
| 1326521048 | Hailey Parks Beckwith | Nurse Practitioner | 635 W Willie Morris Pkwy, Yazoo City, MS 39194 | 2018-09-09 |
| 1003354580 | Wal-mart Stores East, Lp | Technician/Technologist | 2129 Grand Ave, Yazoo City, MS 39194 | 2017-02-06 |
| 1285049593 | Baptist Medical Center - Yazoo, Inc. | Family Medicine | 307 E 15 St., Yazoo City, MS 39194 | 2014-06-25 |
| 1326453648 | Kings Daughters Hospital of Yazoo County, Inc | General Acute Care Hospital | 748 E 15 St., Yazoo City, MS 39194 | 2014-06-25 |
| 1033440268 | Medical Foundation of Central Mississippi | Internal Medicine | 828 Grand Avenue, Yazoo City, MS 39194 | 2010-01-28 |
| 1659537884 | Family Dental Clinic of Yazoo City, LLC | Dentist | 15415 Highway 49 South, Yazoo City, MS 39194 | 2008-08-07 |
| 1245403351 | Eyedeal Optical Yazoo City LLC | Optometrist | 728 East 15th Street, Yazoo City, MS 39194 | 2008-04-09 |
| 1245400423 | Stefanie Patterson Dendy | General Acute Care Hospital | 825 Grand Avenue, Yazoo City, MS 39194 | 2008-03-04 |
| 1144499245 | Martha Coker Home, Inc. | Skilled Nursing Facility | 2041 Grand Avenue, Yazoo City, MS 39194 | 2008-02-22 |
| Find all providers in zip 39194 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770696213 | Yazoo Family Healthcare,llc | Clinic/Center | 307 E Fifteenth St, Yazoo City, MS 39194-2631 | 2006-08-17 |
| 1578812384 | American Psych Associates, Inc | Clinic/Center | 129 S Main St, Yazoo City, MS 39194-4007 | 2012-09-07 |
| 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 | YAZOO CITY |
| Zip Code | 39194 |
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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.