GLOSTER NORTH FAMILY MEDICAL CLINIC INC (NPI# 1356415244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356415244 |
| Entity Type | Organization |
| Organization Name | GLOSTER NORTH FAMILY MEDICAL CLINIC INC |
| Practice Address |
1714 N Gloster St Tupelo MS 38804-1216 |
| Practice Telephone | 6628415086 |
| Practice Fax Number | 6628415088 |
| Mailing Telephone | 6628415086 |
| Mailing Fax Number | 6628415088 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. MARY ANNE MASON (OWNER) |
| Authorized Official Telephone | 6628415086 |
| Authorized Official Credential | APRN, BC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | R866369 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1714 N GLOSTER ST |
| City | TUPELO |
| State | MS |
| Zip Code | 38804-1216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033499744 | Innovative Prosthetic Care Tupelo LLC | Durable Medical Equipment & Medical Supplies | 1714 N Gloster St, Tupelo, MS 38804-1216 | 2011-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548874159 | Susan Me'chelle Oliver | Nurse Practitioner | 874 Barnes Crossing Road, Tupelo, MS 38804 | 2020-09-01 |
| 1134762784 | Kimberly J Adams | Occupational Therapy Assistant | 90 Clark Ave, Tupelo, MS 38804 | 2019-10-25 |
| 1790270924 | Megan Guntharp | Occupational Therapist | 960 Commonwealth Boulevard, Tupelo, MS 38804 | 2018-06-29 |
| 1154867562 | Urologic Ambulatory Surgery Center, LLC | Clinic/Center | 3353 N Gloster Street, Suite 300, Tupelo, MS 38804 | 2017-01-09 |
| 1790235919 | Dr Scott Dickinson D.m. D. PC | Dentist | 3999 N Gloster Street, Tupelo, MS 38804 | 2016-10-12 |
| 1326496621 | Angela Estes | Occupational Therapist | County Road 1279 House#197, Tupelo, MS 38804 | 2016-05-26 |
| 1316300080 | Eric Wade Tillotson | Family Medicine | 1665 South Green Street, Tupelo, MS 38804 | 2016-03-31 |
| 1104238898 | Stella M. Johnson | Social Worker | 2292 Camelot Cir, Tupelo, MS 38804 | 2014-05-29 |
| 1821437351 | Lenka Petersen | Student in an Organized Health Care Education/Training Program | 1665 S Green St., Nmmc, Tupelo, MS 38804 | 2013-06-18 |
| 1083966303 | Jessica M Baskett | Counselor | 398 E Main St, Tupelo, MS 38804 | 2012-10-10 |
| Find all providers in zip 38804 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740821941 | Katelyn C Boren | Nurse Practitioner | 499 Gloster Creek Vlg Ste A1, Tupelo, MS 38801-4749 | 2019-09-30 |
| 1538725478 | Kristen Marie Bailey | Nurse Practitioner | 131 Drive 1756, Tupelo, MS 38804-7605 | 2019-05-16 |
| 1720562762 | Sara Elizabeth Harrington | Nurse Practitioner | 499 S Gloster St Ste A1, Tupelo, MS 38801-5539 | 2018-09-15 |
| 1073092326 | Lauren Parrish | Nurse Practitioner | 1573 Medical Park Circle, Tupelo, MS 38801 | 2018-08-08 |
| 1952609802 | Morgan Barker | Nurse Practitioner | 990 S Madison St Ste 1, Tupelo, MS 38801-6308 | 2011-03-02 |
| 1760536783 | Lauren Mcgee Babb | Nurse Practitioner | 2633 Traceland Dr, Tupelo, MS 38801-4238 | 2007-01-23 |
| 1851484240 | Nicole M Hindman | Nurse Practitioner | 4381 South Eason Blvd, Tupelo, MS 38801 | 2006-09-30 |
| 1619984390 | Angel S, Harbin | Nurse Practitioner | 149 N Eason Blvd, Tupelo, MS 38804 | 2006-08-02 |
| 1699781765 | Zandra Dawn Frans | Nurse Practitioner | 891 Mississippi Dr, Tupelo, MS 38804-0934 | 2006-07-31 |
| 1538190418 | Lauri Mckell | Nurse Practitioner | 830 S Gloster Street, 4th Floor East Tower, Tupelo, MS 38801 | 2006-07-06 |
| Find all providers in TUPELO | ||||
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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.