KID'S CLINIC, PLLC (NPI# 1477642791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477642791 |
| Entity Type | Organization |
| Organization Name | KID'S CLINIC, PLLC |
| Practice Address |
9325c Highway 19 N Collinsville MS 39325-9219 |
| Practice Telephone | 6014272752 |
| Practice Fax Number | 6014272800 |
| Mailing Telephone | 6014272752 |
| Mailing Fax Number | 6014272800 |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2013-06-04 |
| Authorized Official Name | DR. TAMMY N HENDERSON (OWNER) |
| Authorized Official Telephone | 6014272752 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 13886 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00121471 | 05 |
| Street Address |
9325C HIGHWAY 19 N |
| City | COLLINSVILLE |
| State | MS |
| Zip Code | 39325-9219 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801997606 | Tammy N Henderson | General Practice | 9325c Highway 19 N, Collinsville, MS 39325-9219 | 2006-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033609409 | Anna Victoria Stewart | Speech-Language Pathologist | 11790 Pine Grove Rd, Collinsville, MS 39325 | 2018-05-11 |
| 1083160782 | Chandra Sumlin-brown Dba Sumlin Behavioral Services | Psychiatric Hospital | 8237b Okatibbee Dam Road, Collinsville, MS 39325 | 2016-09-01 |
| 1982948980 | Lisa Wiliams | Registered Nurse | 8237 A Okatibbee Dam Rd, Collinsville, MS 39325 | 2012-11-15 |
| 1770883688 | Collinsville Family Dental | Dentist | 9171 A, Old Hwy 19n, Collinsville, MS 39325 | 2010-10-26 |
| 1942550280 | Adam Turbyfill | Pharmacist | 9155 Hwy 19, Collinsville, MS 39325-0175 | 2012-09-13 |
| 1811001878 | Collinsville Drugs Inc | Pharmacy | 9158 Hwy 19, Collinsville, MS 39325-0175 | 2006-08-18 |
| 1184238396 | Veronica Necole Mcfadden | Student in an Organized Health Care Education/Training Program | 8583 Wilsondale Rd, Collinsville, MS 39325-8957 | 2020-09-04 |
| 1659688422 | Oya Weston Hampton | Counselor | 9056b Collinsville Rd, Collinsville, MS 39325-9100 | 2010-09-01 |
| 1053635565 | Heather Stinson | Counselor | 9101 Collinsville Rd, Collinsville, MS 39325-9224 | 2010-03-26 |
| 1407493596 | Kristen Thames | Nurse Practitioner | 11115 Hill Thompson Rd, Collinsville, MS 39325-9313 | 2019-12-08 |
| Find all providers in zip 39325 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801997606 | Tammy N Henderson | General Practice | 9325c Highway 19 N, Collinsville, MS 39325-9219 | 2006-09-26 |
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|---|---|---|---|---|
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| 1518500677 | Nettleton Medical Express Care LLC | General Practice | 7230 Highway 45 N Ste B, 32610 Hwy 45 N, Nettleton, MS 38858 | 2019-10-22 |
| 1780241729 | Southeast Reginald Solutions,pllc | General Practice | 310 River Forest Ln, Brandon, MS 39047-7020 | 2019-05-24 |
| 1235601907 | William Carey University | General Practice | 710 William Carey Pkwy, Hattiesburg, MS 39401-7842 | 2018-12-19 |
| 1770050908 | Thompson Medical Service, LLC | General Practice | 1200 Hwy 15 North, Blue Mountain, MS 38610 | 2018-10-25 |
| 1790265932 | Antonio Reyes Del Castillo Jr. | General Practice | 590 Parchman Road 12, Parchman, MS 38738-3001 | 2018-08-16 |
| 1700397239 | Marysol Camejo Romero | General Practice | 728 Benwick Dr, Brandon, MS 39047-8111 | 2017-10-24 |
| 1013431519 | Madena Jane Gibson | General Practice | 1695 Moses Rd, Raymond, MS 39154-8766 | 2017-07-27 |
| 1942740188 | Personalized Wellness | General Practice | 573 Highway 51 Ste D, Ridgeland, MS 39157-2605 | 2017-03-07 |
| 1366991523 | Jackson State University | General Practice | 1400 Jr Lynch St, Jackson, MS 39217-0002 | 2016-09-29 |
| Find all providers with the same taxonomy | ||||
| City | COLLINSVILLE |
| Zip Code | 39325 |
Please comment or provide details below to improve the information on KID'S CLINIC, PLLC.
| 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.