MICKEY DAVIS WOOTEN (NPI# 1255602280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255602280 |
| Entity Type | Individual |
| Full Name | MICKEY DAVIS WOOTEN |
| Practice Address |
5254 County Line Rd Carthage MS 39051-8063 |
| Practice Telephone | 6012980025 |
| Practice Fax Number | 6012980029 |
| Mailing Telephone | 6012980025 |
| Mailing Fax Number | 6012980029 |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2012-01-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 172A00000X | Driver | 06359874 | MS | Other Service Providers |
| N | 372600000X | Adult Companion | 02426031 | MS | Nursing Service Related Providers |
| Y | 376J00000X | Homemaker | 00770591 | MS | Nursing Service Related Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 02426031 | 05 | |
| MS | 00770591 | 05 | |
| MS | 06359874 | 05 |
| Street Address |
5254 COUNTY LINE RD |
| City | CARTHAGE |
| State | MS |
| Zip Code | 39051-8063 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598275828 | Roots Healthcare and Homes, LLC | Meals | 292 Pickens Circle, Carthage, MS 39051 | 2017-09-30 |
| 1427575505 | Trend Health and Rehab of Carthage | Skilled Nursing Facility | 1101 E. Franklin Street, Carthage, MS 39051 | 2017-08-29 |
| 1750738415 | Telehealthone LLC | Nurse Practitioner | 300 South Pearl Street, Carthage, MS 39051 | 2016-05-23 |
| 1316297575 | Silver Lining Adult Daycare, LLC | Respite Care | 531 Highway 35 North, Carthage, MS 39051 | 2012-09-14 |
| 1508179888 | Mississippi Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 205 Highway 16 West, Carthage, MS 39051 | 2010-07-15 |
| 1376725754 | Amye L Shamburger | Dentist | 101 S. Pearl Street, Carthage, MS 39051 | 2007-11-28 |
| 1770786188 | Carthage Eye Clinic Pa | Optometrist | 201 Hwy 16 East, Carthage, MS 39051 | 2007-06-06 |
| 1265553762 | David C Henderson | Dentist | 113 North Pearl St, Carthage, MS 39051 | 2007-04-02 |
| 1780722280 | Linda N Roland | Nurse Practitioner | 204 Chipley St., Carthage, MS 39051 | 2007-02-05 |
| 1205914298 | William M Myers II | Dentist | 12646 Hwy 488, Carthage, MS 39051 | 2006-11-01 |
| Find all providers in zip 39051 | ||||
| Taxonomy Code | 376J00000X |
| Grouping | Nursing Service Related Providers |
| Classification | Homemaker |
| An individual who provides general household activities such as meal preparation, laundry, and light housekeeping, when the individual regularly responsible for these activities is temporarily absent or unable to provide for himself. Homemakers must meet the state defined training standards. |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982249702 | Patricia A Holloway | Homemaker | 115 S Pearl St, Carthage, MS 39051-4131 | 2019-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063011682 | Tiffany Denice Redd | Homemaker | 15092 S Jackson St, Durant, MS 39063-3900 | 2020-10-23 |
| 1952924763 | Southern Touch Homemaker & Comfort Agency LLC | Homemaker | 501a Lumberton Rd, Columbia, MS 39429-3515 | 2020-05-27 |
| 1831710714 | Annette Santiago | Homemaker | 2019 Springwood Rd, Gautier, MS 39553-7301 | 2020-05-01 |
| 1548895261 | More Than Help Healthcare Services LLC | Homemaker | 124 Carriage Ln, Florence, MS 39073-6015 | 2020-03-04 |
| 1467083907 | Ratoya Walker | Homemaker | 34 Jims Rd, Columbia, MS 39429-8265 | 2020-02-03 |
| 1124662531 | Dorothy M Moore | Homemaker | 2211 Highway 45 N Ste G2211, Meridian, MS 39301-2730 | 2019-10-30 |
| 1912548181 | Tammy S Ramsey | Homemaker | 4653 Highway 15 N, Laurel, MS 39443-9473 | 2019-09-30 |
| 1780232801 | Kimberly Thompson | Homemaker | 230 Sawyer Rd, Winona, MS 38967-9504 | 2019-09-02 |
| 1376103408 | Deneitra Jones | Homemaker | 131 Bainbridge Xing, Canton, MS 39046-6031 | 2019-06-20 |
| 1356901516 | Tammy Mark | Homemaker | 2009 Highway 98 W, Foxworth, MS 39483-5021 | 2019-06-19 |
| Find all providers with the same taxonomy | ||||
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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.