HATTIESBURG CLINIC, PA (NPI# 1356781082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356781082 |
| Entity Type | Organization |
| Organization Name | HATTIESBURG CLINIC, PA |
| Other Organization Name | IMMEDIATE CARE - CARRIERE |
| Practice Address |
6941 Highway 11 N Suite A Carriere MS 39426-7793 |
| Mailing Address |
415 S 28th Ave Hattiesburg MS 39401-7246 |
| Practice Telephone | 6017493776 |
| Mailing Telephone | 6015795463 |
| Mailing Fax Number | 6015795240 |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2015-08-05 |
| Authorized Official Name | TOMMY G. THORNTON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6012685601 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 03833301 | 05 |
| Other Name | Type Code |
|---|---|
| Immediate Care - Carriere | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295392074 | Hattiesburg Clinic, Pa | Preventive Medicine | 6414 Highway 98, Suite 120, Hattiesburg, MS 39402 | 2019-05-28 |
| 1679053979 | Hattiesburg Clinic, Pa | Family Medicine | South 28th Avenue Family Medicine, 1101 South 28th Avenue, Suite C, Hattiesburg, MS 39402 | 2018-08-16 |
| 1750882080 | Hattiesburg Clinic, Pa | Physical Medicine & Rehabilitation | 2 Southern Point Pkwy Ste 200, Hattiesburg, MS 39401-8025 | 2018-02-22 |
| 1801310768 | Hattiesburg Clinic, Pa | Clinic/Center | 5909 Hwy 49 S, Suite 14, Hattiesburg, MS 39402-2860 | 2017-08-01 |
| 1346780681 | Hattiesburg Clinic, Pa | Family Medicine | 202 E Main Ave, Lumberton, MS 39455-2608 | 2017-03-06 |
| 1689830549 | Hattiesburg Clinic, Pa | Physical Therapist | 1403 S Main St Ste E, Poplarville, MS 39470-3394 | 2008-07-31 |
| 1841494895 | Hattiesburg Clinic, Pa | Clinic/Center | 103 Asbury Cir, Hattiesburg, MS 39402-1302 | 2007-06-13 |
| 1669405981 | Hattiesburg Clinic, Pa | Clinic/Center | 14 Bay Ave, Bay Springs, MS 39422-9206 | 2006-07-09 |
| 1245263540 | Hattiesburg Clinic, Pa | Clinic/Center | 1527 Larry Dr, Laurel, MS 39440-1932 | 2006-07-09 |
| 1821021155 | Hattiesburg Clinic, Pa | Clinic/Center | 4820 Plaza Dr, Tylertown, MS 39667-9221 | 2006-07-09 |
| Street Address |
6941 HIGHWAY 11 N SUITE A |
| City | CARRIERE |
| State | MS |
| Zip Code | 39426-7793 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689866477 | Lambert Dental PC | Dentist | 6480 Hwy 11 North, Carriere, MS 39426 | 2007-08-15 |
| 1427115641 | Aquatic Therapy Services, LLC | Clinic/Center | 10 Carrie Mitchell Rd, Carriere, MS 39426 | 2007-01-03 |
| 1285108662 | Sara A Duncan | Family Medicine | 200 Country Club Rd, Carriere, MS 39426 | 2019-01-18 |
| 1619008174 | Forrest County General Hospital | Internal Medicine | 200 Country Club Rd, Carriere, MS 39426 | 2007-03-08 |
| 1679035273 | Align Health LLC | Non-emergency Medical Transport (VAN) | 74 Pops Rdg, Carriere, MS 39426-5142 | 2019-04-02 |
| 1093325409 | Justin Robert Ragon | Nurse Practitioner | 40 Roosters Ln, Carriere, MS 39426-7022 | 2020-07-31 |
| 1235200304 | John W Houston | Physical Therapist | 48 Camellia Rd, Carriere, MS 39426-7077 | 2006-11-12 |
| 1093927220 | Devereux and Nguyen LLC | Dentist | 6420 Highway 11, Suite C, Carriere, MS 39426-7145 | 2007-05-03 |
| 1790274603 | Gregory Goggans, D.m.d., P.C. | Dentist | 6420 Highway 11 N Ste C, Carriere, MS 39426-7146 | 2018-05-07 |
| 1407358146 | Melissa Loewen | Specialist/Technologist | 7407 Highway 11, Carriere, MS 39426-7484 | 2018-03-07 |
| Find all providers in zip 39426 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285108662 | Sara A Duncan | Family Medicine | 200 Country Club Rd, Carriere, MS 39426 | 2019-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900581 | Maegan Cook Bridges | Family Medicine | 312 Ridge Pointe Dr, Brandon, MS 39042-5035 | 2020-10-24 |
| 1003415266 | Christian Fortenberry | Family Medicine | 786 Lake Harbour Dr, Ridgeland, MS 39157-4303 | 2020-10-20 |
| 1457967226 | Tiffine Lynn Prisock | Family Medicine | 24978 Ms-15, Mathiston, MS 39752 | 2020-09-17 |
| 1851902860 | Jasmine Lester | Family Medicine | 538 Getwell Rd S, Hernando, MS 38632-9585 | 2020-08-12 |
| 1942810569 | Ericka Marcene Williams | Family Medicine | 1031 Northridge Rd Ste A, Baldwyn, MS 38824-1173 | 2020-08-07 |
| 1316557986 | Independent Healthcare Management, Inc | Family Medicine | 376 Simpson Highway 149 Ste 600, Magee, MS 39111-3572 | 2020-08-07 |
| 1164031373 | Rohith Reddy Guduru Venkata | Family Medicine | Delta Regional Medical Center, 1400 E Union St, Greenville, MS 38703 | 2020-07-24 |
| 1831707470 | Rebecca Holmes | Family Medicine | 42 Atley Holmes Rd # Rs, Jayess, MS 39641-8272 | 2020-07-20 |
| 1497373344 | Dhruval Patel | Family Medicine | 564 Cypress Ln Apt 11d, Greenville, MS 38701-7415 | 2020-07-08 |
| 1881211258 | Tiffany Chapman | Family Medicine | 905 S Frontage Rd, Meridian, MS 39301-6113 | 2020-07-01 |
| 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.