WOMAN'S CLINIC, A PROFESSIONAL ASSOCIATION (NPI# 1477898112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477898112 |
| Entity Type | Organization |
| Organization Name | WOMAN'S CLINIC, A PROFESSIONAL ASSOCIATION |
| Practice Address |
2000 N State St Clarksdale MS 38614-6100 |
| Practice Telephone | 6626277361 |
| Practice Fax Number | 6626274793 |
| Mailing Telephone | 6626277361 |
| Mailing Fax Number | 6626274793 |
| Enumeration Date | 2012-12-06 |
| Last Update Date | 2019-12-12 |
| Authorized Official Name | KUSHNA K DAMALLIE (PRESIDENT) |
| Authorized Official Telephone | 6626277361 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | Other Service Providers | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 08321779 | 05 | |
| RHC MEDICARE | 258977 | 01 |
| Street Address |
2000 N STATE ST |
| City | CLARKSDALE |
| State | MS |
| Zip Code | 38614-6100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346233442 | Bouldin A Marley Jr. | Specialist | 2000 N State St, Clarksdale, MS 38614-6100 | 2005-08-24 |
| 1346735057 | Teresa Victoria White Powell | Nurse Practitioner | 2000 N State St, Clarksdale, MS 38614-6100 | 2018-06-25 |
| 1215195631 | Kimberly Tanner Fava | Nurse Practitioner | 2000 N State St, Clarksdale, MS 38614-6100 | 2008-06-02 |
| 1629293113 | Frank T. Marascalco, M.d., P.a. | Specialist | 2000 N State St, Clarksdale, MS 38614-6100 | 2007-04-17 |
| 1730104928 | Delphia M Hord | Specialist | 2000 N State St, Clarksdale, MS 38614-6100 | 2006-07-12 |
| 1982690061 | Linda D Wright | Nurse Practitioner | 2000 N State St, Clarksdale, MS 38614-6100 | 2005-09-23 |
| 1366438772 | Erica R Balthrop | Specialist | 2000 N State St, Clarksdale, MS 38614-6100 | 2005-09-21 |
| 1861488215 | Kushna K Damallie | Specialist | 2000 N State St, Clarksdale, MS 38614-6100 | 2005-09-21 |
| 1043203136 | Womans Clinic, A Professional Association | Specialist | 2000 N State St, Clarksdale, MS 38614-6100 | 2005-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386265627 | Lillie Mae Lockett | Technician | 1025 Ritchie Ave, Clarksdale, MS 38614 | 2020-04-28 |
| 1063957751 | Autospa-healthy Youth Center | Nurse Practitioner | 1202 Desoto Ave, Suite A, Clarksdale, MS 38614 | 2017-01-04 |
| 1700226123 | Nikki Nikkia Cager | Internal Medicine | 785 Ohio Ave Ste 2d, Clarksdale, MS 38614 | 2013-06-29 |
| 1205186947 | Celestial Comfort Care Hospice | Hospice Care, Community Based | 110 Yazoo Ave. Suite 212, Clarksdale, MS 38614 | 2012-09-10 |
| 1063667129 | The Smile Center of Clarksdale | Clinic/Center | 526 Choctaw Street, Suites B & C, Clarksdale, MS 38614 | 2008-11-17 |
| 1801060033 | Clarksdale Municipal School District | Local Education Agency (LEA) | Gycelle Tynes Educational Center, Friars Point Road, Clarksdale, MS 38614 | 2008-04-18 |
| 1184806150 | Mary A Williams | Nurse Practitioner | 125 Highway 322, Clarksdale, MS 38614 | 2007-12-03 |
| 1114040367 | William F Wilson Jr. | Dentist | 850 Desoto Ave, Extended, Clarksdale, MS 38614 | 2007-04-10 |
| 1952434920 | Kathleen Tinnel | Nurse Practitioner | 2245 N State St, Clarksdale, MS 38614 | 2007-03-13 |
| 1497888457 | Carole L Mangrem | Pediatrics | 2245 N Starte St, Clarksdale, MS 38614 | 2007-03-13 |
| Find all providers in zip 38614 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467949941 | Delta Medical Foundation | Clinic/Center | 551 Medical Dr, Clarksdale, MS 38614-6733 | 2018-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730786120 | Ochsner Medical Center - Hancock, LLC | Clinic/Center | 2274 Highway 43 S Ste 200, Picayune, MS 39466-8141 | 2020-10-08 |
| 1306460282 | Covington County Hospital | Clinic/Center | 105 Eaton St, Taylorsville, MS 39168-5614 | 2020-06-05 |
| 1871117747 | Covington County Hospital | Clinic/Center | 1039 Highway 42 Ste C, Sumrall, MS 39482-4478 | 2020-06-05 |
| 1194365338 | Bounds Family Medical | Clinic/Center | 870 Main St Ste A, Fayette, MS 39069-5695 | 2020-01-15 |
| 1720649577 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 19 Third St, Belmont, MS 38827 | 2019-06-24 |
| 1255999611 | Boa Vida Hospital of Aberdeen, Ms LLC | Clinic/Center | 400 3rd Ave 32 West, New Houlka, MS 38850 | 2019-05-31 |
| 1598238545 | South Sunflower County Hospital | Clinic/Center | 1001 West Delta, Moorhead, MS 38761 | 2019-01-02 |
| 1790272185 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 670 Ms-178, Suite 5, Sherman, MS 38869 | 2018-04-20 |
| 1124515515 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 2200 5th St N, Columbus, MS 39705-2212 | 2018-04-20 |
| 1205323698 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 815 2nd Ave N, Columbus, MS 39701-4703 | 2018-04-20 |
| Find all providers with the same taxonomy | ||||
| City | CLARKSDALE |
| Zip Code | 38614 |
Please comment or provide details below to improve the information on WOMAN'S CLINIC, A PROFESSIONAL ASSOCIATION.
| 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.