CLAIBORNE COUNTY FAMILY HEALTH CENTER (NPI# 1235133968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235133968 |
| Entity Type | Organization |
| Organization Name | CLAIBORNE COUNTY FAMILY HEALTH CENTER |
| Other Organization Name | CCFHC |
| Practice Address |
2045 Highway 61 North Port Gibson MS 39150-4262 |
| Mailing Address |
2045 Highway 61 N P O Box 741 Port Gibson MS 39150-4262 |
| Practice Telephone | 6014373049 |
| Practice Fax Number | 6014373051 |
| Mailing Telephone | 6014373049 |
| Mailing Fax Number | 6014373051 |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2013-09-24 |
| Authorized Official Name | MRS. LADONNA BEASLEY DAVIS (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 6014373052 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
MS | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09010054 | 05 |
| Other Name | Type Code |
|---|---|
| CCFHC | Other Name - Individual/Organization |
| Street Address |
2045 HIGHWAY 61 NORTH |
| City | PORT GIBSON |
| State | MS |
| Zip Code | 39150-4262 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740385103 | Demetri W Marshall | Family Medicine | 2045 Highway 61 North, Port Gibson, MS 39150-4262 | 2006-09-13 |
| 1548365901 | Marvell Spears | Nurse Practitioner | 2045 Highway 61 North, Port Gibson, MS 39150-4262 | 2006-09-13 |
| 1427160654 | Keith D Bishop | Dentist | 2045 Highway 61 North, Port Gibson, MS 39150-4262 | 2006-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326113135 | Eli George Ellis Jr. | Dentist | 911 Market St, Port Gibson, MS 39150 | 2006-11-21 |
| 1528032406 | David Mccaa Headley | Family Medicine | 405 Market St, Port Gibson, MS 39150 | 2006-02-15 |
| 1144500091 | Latoya Denise Colenberg Eakins | Dentist | 2045 Highway 61 N, Port Gibson, MS 39150 | 2011-08-24 |
| 1982914628 | Delarious Oneal Stewart | Counselor | 404 Market St, Port Gibson, MS 39150 | 2010-10-15 |
| 1104904457 | Claiborne County Hospital | Medicare Defined Swing Bed Unit | 123 Mccomb Avenue, Port Gibson, MS 39150-1004 | 2006-11-02 |
| 1073176749 | Ginetta Felton Anderson | Nurse Practitioner | 405 Market St, Port Gibson, MS 39150-2024 | 2019-04-18 |
| 1265753172 | Jennifer Leigh Greer | Nurse Practitioner | 405 Market St, Port Gibson, MS 39150-2024 | 2010-06-15 |
| 1578627782 | David M. Headley, M.d. Pa | Family Medicine | 405 Market St, Port Gibson, MS 39150-2024 | 2006-12-21 |
| 1427296748 | Claiborne County School District | Local Education Agency (LEA) | 404 Market St, Port Gibson, MS 39150-2025 | 2009-01-23 |
| 1235394966 | Claiborne County Family Health Center, Inc. | Clinic/Center | 880 Anthony St, 2045 Highway 61 North, Port Gibson, MS 39150-2050 | 2008-07-22 |
| Find all providers in zip 39150 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881859338 | Claiborne County Family Health Center, Inc. | Clinic/Center | 161 Ramsey Dr, 2045 Highway 61 North, Port Gibson, MS 39150-2531 | 2008-07-24 |
| 1235394966 | Claiborne County Family Health Center, Inc. | Clinic/Center | 880 Anthony St, 2045 Highway 61 North, Port Gibson, MS 39150-2050 | 2008-07-22 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | PORT GIBSON |
| Zip Code | 39150 |
Please comment or provide details below to improve the information on CLAIBORNE COUNTY FAMILY HEALTH CENTER.
| 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.