CHILDRENS HEALTH CLINIC (NPI# 1275158776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275158776 |
| Entity Type | Organization |
| Organization Name | CHILDRENS HEALTH CLINIC |
| Practice Address |
340 Van Dorn St Grenada MS 38901-4738 |
| Practice Telephone | 6622260325 |
| Practice Fax Number | 6622260327 |
| Mailing Telephone | 6622260325 |
| Mailing Fax Number | 6622260327 |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-07-17 |
| Authorized Official Name | MELANIE RENAE WILLIAMS (NURSE/OWNER) |
| Authorized Official Telephone | 6622260325 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
340 VAN DORN ST |
| City | GRENADA |
| State | MS |
| Zip Code | 38901-4738 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336133453 | James Ward Fite | Pediatrics | 340 Van Dorn St, Grenada, MS 38901-4738 | 2005-09-02 |
| 1861845950 | Cynthia Lynn Burchfield | Nurse Practitioner | 340 Van Dorn St, Grenada, MS 38901-4738 | 2016-07-13 |
| 1912321175 | Gwendolyn Sprayberry Lordeon | Nurse Practitioner | 340 Van Dorn St, Grenada, MS 38901-4738 | 2014-02-09 |
| 1609109560 | H. David Simmons | Pediatrics | 340 Van Dorn St, Grenada, MS 38901-4738 | 2009-09-10 |
| 1821321993 | James W. Fite, Md | Pediatrics | 340 Van Dorn St, Grenada, MS 38901-4738 | 2009-09-08 |
| 1497742704 | Harold David Simmons | Pediatrics | 340 Van Dorn St, Grenada, MS 38901-4738 | 2005-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902435118 | The Mane Physician | Prosthetic/Orthotic Supplier | 94 Spain Drive, Grenada, MS 38901 | 2020-04-08 |
| 1942842166 | Sylvia C Bass | Technician | 813 Union Street, Grenada, MS 38901 | 2019-10-09 |
| 1669971180 | Jenny Taylor | Nurse Practitioner | 350 Sunset Drive, Grenada, MS 38901 | 2018-02-10 |
| 1073912762 | John Thomas Mcree I | Counselor | 2026 Commerce St Ste 8e, Grenada, MS 38901 | 2014-08-19 |
| 1700213634 | State of Mississippi-university of Mississippi Medical Center | Home Health | 960 Avent Drive, Grenada, MS 38901 | 2013-10-10 |
| 1114359866 | Cmhp Enterprises | Dentist | 1420 Wooded Drive, Grenada, MS 38901 | 2013-08-05 |
| 1518256460 | Mercy Hospice LLC | Hospice Care, Community Based | 1410 Wooded Drive, Grenada, MS 38901 | 2011-03-31 |
| 1215256318 | Della Lea Welsh | Speech-Language Pathologist | 1321 Dd Sunset Dr., Grenada, MS 38901 | 2010-05-28 |
| 1750514543 | Family Health Care Clinic, Inc. | Clinic/Center | 1102 Telegraph St, Grenada, MS 38901 | 2009-08-27 |
| 1033384771 | Jason K Bennett | Pharmacist | 140 Shadow Wood Cv, Grenada, MS 38901 | 2008-04-24 |
| Find all providers in zip 38901 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669971180 | Jenny Taylor | Nurse Practitioner | 350 Sunset Drive, Grenada, MS 38901 | 2018-02-10 |
| 1306126263 | Charles Raymond Jordan | Nurse Practitioner | 1350 Sunset Dr Ste B, Grenada, MS 38901-4079 | 2011-08-24 |
| 1144400607 | Family Health Clinic of Grenada | Nurse Practitioner | 1117 Sunset Dr Ste 104, Grenada, MS 38901-4080 | 2007-11-13 |
| 1194947754 | Shonda Jacqueline Phelon | Nurse Practitioner | 1970 Grandview Dr, Grenada, MS 38901-5066 | 2007-05-03 |
| 1629103510 | Sandra Flint Melton | Nurse Practitioner | 1241 S Mound St Ste A, Grenada, MS 38901-4515 | 2007-02-22 |
| 1619987427 | Debbie Elizabeth Mcgehee | Nurse Practitioner | 100 East Monroe Street, Grenada, MS 38901-4080 | 2006-08-08 |
| 1720057565 | Cynthia C Dotson | Nurse Practitioner | 965 Avent Dr Ste 105, Grenada, MS 38901-5045 | 2006-03-15 |
| 1841299500 | Nell Catherine Brock | Nurse Practitioner | 108 Vfw Rd, Grenada, MS 38901 | 2005-07-15 |
| 1013515980 | Aarrin Marie Mcdougal | Nurse Practitioner | 100 E Monroe St, Grenada, MS 38901-5249 | 2020-10-13 |
| 1205441375 | Alison Campbell | Nurse Practitioner | 1117 Sunset Dr Ste 104, Grenada, MS 38901-4080 | 2020-09-15 |
| Find all providers in GRENADA | ||||
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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.