CASSIDY BAYOU MEDICAL CLINIC (NPI# 1376181990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376181990 |
| Entity Type | Organization |
| Organization Name | CASSIDY BAYOU MEDICAL CLINIC |
| Practice Address |
2372 Us 49-e Sumner MS 38957 |
| Mailing Address |
Po Box 240 Sumner MS 38957-0240 |
| Practice Telephone | 6623759310 |
| Mailing Telephone | 6623759310 |
| Mailing Fax Number | 6623759311 |
| Enumeration Date | 2019-12-13 |
| Last Update Date | 2020-04-27 |
| Authorized Official Name | SONJA BUSH PENNINGTON (PROVIDER/OWNER) |
| Authorized Official Telephone | 6623752363 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
2372 US 49-E |
| City | SUMNER |
| State | MS |
| Zip Code | 38957 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113304 | Tasha Rucker | Nurse Practitioner | 2372 Us49-e, Sumner, MS 38957 | 2020-10-27 |
| 1386180610 | Sonja Pennington | Nurse Practitioner | 2372 Us-49e Unit 240, Sumner, MS 38957 | 2017-01-10 |
| 1811234636 | Westside Family Medical Clinic Pllc | Clinic/Center | 2372 Ms Highway 49 East, Sumner, MS 38957 | 2013-01-14 |
| 1306966502 | Court Square Rural Health Clinic | Nurse Practitioner | 406 East Court St., Sumner, MS 38957 | 2007-03-30 |
| 1043212996 | Aaron E Henry Community Health | Clinic/Center | Friendship Rd, Sumner, MS 38957 | 2005-08-11 |
| 1356555080 | Hudson Sumner Drugs | Pharmacy | 108 N Court, Sumner, MS 38957 | 2007-05-10 |
| 1023428703 | Mississippi State Department of Health | Public Health or Welfare | 208 Wilson Street, Sumner, MS 38957-0000 | 2014-05-02 |
| 1952473571 | W & D Pharmacy Inc | Pharmacy | 110 Court Square, Sumner, MS 38957-0217 | 2006-11-15 |
| 1316040850 | Robert L Tucker | Nurse Practitioner | 2372 Hwy 49 East, Sumner, MS 38957-0250 | 2006-09-07 |
| 1275616831 | Ewell Spencer Hudson | Pharmacist | 108 N Court, Sumner, MS 38957-0526 | 2006-10-24 |
| Find all providers in zip 38957 | ||||
| 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 |
|---|---|---|---|---|
| 1316389430 | Wei Kong Chang Estate | Family Medicine | 1004 E 1st St, Sumner, IA 50674-1618 | 2013-07-18 |
| 1811004351 | Charles J Kucera | Family Medicine | 5814 Graham Ave Ste 100, Sumner, WA 98390-2728 | 2006-08-23 |
| 1902820020 | Kent R Walker | Family Medicine | 16202 64th St E Ste 104, Sumner, WA 98390-3028 | 2006-07-26 |
| 1538120506 | Sumner Medical Clinic PC | Family Medicine | 909 W 1 St, Sumner, IA 50674 | 2006-03-30 |
| 1336602762 | Maua Wingi Swai | Family Medicine | 15324 Main St E Ste B, Sumner, WA 98390-2698 | 2019-04-11 |
| 1740682434 | Chang Cornerstone Clinic | Family Medicine | 1004 E 1st St, Sumner, IA 50674-1618 | 2014-09-24 |
| 1396056073 | Jeffrey Ronald Roske | Family Medicine | 909 W 1st St, Sumner, IA 50674-1203 | 2010-06-28 |
| 1528295680 | Ted Le Schwarm | Family Medicine | 909 W 1st St, Sumner, IA 50674-1203 | 2009-06-16 |
| 1184844946 | Michelle Rae Show | Family Medicine | 1518 Main St, Sumner, WA 98390-1812 | 2007-04-26 |
| 1013029222 | William E. Biljan | Family Medicine | 5814 Graham Ave, Suite 100, Sumner, WA 98390-2728 | 2006-09-01 |
| Find all providers in SUMNER | ||||
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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.