HATTIESBURG CLINIC, PA (NPI# 1669405981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669405981 |
| Entity Type | Organization |
| Organization Name | HATTIESBURG CLINIC, PA |
| Other Organization Name | BAY SPRINGS DIALYSIS UNIT |
| Practice Address |
14 Bay Ave Bay Springs MS 39422-9206 |
| Mailing Address |
415 S 28th Ave Hattiesburg MS 39401-7246 |
| Practice Telephone | 6017646427 |
| Practice Fax Number | 6017646429 |
| Mailing Telephone | 6012685700 |
| Mailing Fax Number | 6012685777 |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2014-08-27 |
| Authorized Official Name | TOMMY G THORNTON (EXECUTIVE DIRECTCOR) |
| Authorized Official Telephone | 6012685601 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00220502 | 05 | |
| MS | BLUE CROSS BLUE SHIELD MS | 000050575 | 01 |
| MS | UNITED HEALTHCARE | 5000477 | 01 |
| Other Name | Type Code |
|---|---|
| Bay Springs Dialysis Unit | 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 |
| 1356781082 | Hattiesburg Clinic, Pa | Family Medicine | 6941 Highway 11 N, Suite A, Carriere, MS 39426-7793 | 2013-06-26 |
| 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 |
| 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 |
14 BAY AVE |
| City | BAY SPRINGS |
| State | MS |
| Zip Code | 39422-9206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952873994 | Family Health Care Clinic, Inc | Clinic/Center | 298 Hwy 18 West, Bay Springs, MS 39422 | 2018-12-31 |
| 1578019808 | Rebecca Little | Nurse Practitioner | 27 S. 6th Street, Bay Springs, MS 39422 | 2016-08-28 |
| 1689930372 | Region Ten Commission On Mental Health | Clinic/Center | 9 North Second Street, Bay Springs, MS 39422 | 2012-04-06 |
| 1760790778 | Bay Springs Eye Care LLC | Optometrist | 16 South 6th Street, Bay Springs, MS 39422 | 2010-09-24 |
| 1174787915 | Tracy Lee Williams | Dentist | 12 South 6th Street, Bay Springs, MS 39422 | 2008-07-10 |
| 1316137052 | Bethany Ann South | Optometrist | 16 South 16th St, Bay Springs, MS 39422 | 2007-07-30 |
| 1972717858 | Dr. Benjamin J. Hodges and Associates, P.a. | Dentist | 2683 Hwy. 15, 2683 Hwy. 15, Bay Springs, MS 39422 | 2007-05-09 |
| 1003983420 | Paul Alan Little | Chiropractor | 13 East 8th Avenue, Bay Springs, MS 39422 | 2006-11-29 |
| 1194825513 | Mary E Clawson | Internal Medicine | Family Medical Clinic, 20 South 6th Street, Bay Springs, MS 39422 | 2006-09-25 |
| 1023118817 | Jasper General Hospital | Durable Medical Equipment & Medical Supplies | 15 A South 6th Street, Bay Springs, MS 39422 | 2006-09-22 |
| Find all providers in zip 39422 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760092878 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 5722 I-55 N Frontage Road, Jackson, MS 39211 | 2020-08-04 |
| 1952910457 | Fresenius Medical Care East Mccomb Dialysis, LLC | Clinic/Center | 103 Business Center Drive, Mccomb, MS 39648 | 2020-07-30 |
| 1013535780 | Fresenius Medical Care Meridian Home, LLC | Clinic/Center | 2400 15th St, Meridian, MS 39301-3951 | 2020-07-09 |
| 1922631837 | Fresenius Medical Care Dogwood, LLC | Clinic/Center | 205b Belle Meade Pt, Flowood, MS 39232-3311 | 2020-02-19 |
| 1669944120 | Fresenius Medical Care Adams County Home, LLC | Clinic/Center | 151 Jefferson Davis Blvd Ste D, Natchez, MS 39120-5140 | 2018-12-21 |
| 1205334513 | Renal Care Group Tupelo, LLC | Clinic/Center | 1031 S Madison St, Tupelo, MS 38801-6309 | 2018-02-01 |
| 1801310768 | Hattiesburg Clinic, Pa | Clinic/Center | 5909 Hwy 49 S, Suite 14, Hattiesburg, MS 39402-2860 | 2017-08-01 |
| 1184146789 | Lakeland Home Program LLC | Clinic/Center | 209 Mar Lyn Dr, Brandon, MS 39042 | 2017-07-14 |
| 1932636495 | Rcg Mississippi, Inc. | Clinic/Center | 1300 38th Ave E, Meridian, MS 39301 | 2017-05-16 |
| 1710411707 | Rcg Mississippi, Inc. | Clinic/Center | 1100 Central Drive, Philadelphia, MS 39350 | 2017-04-17 |
| Find all providers with the same taxonomy | ||||
| City | BAY SPRINGS |
| Zip Code | 39422 |
Please comment or provide details below to improve the information on HATTIESBURG CLINIC, PA.
| 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.