EVERGREEN FAMILY MEDICAL CLINIC INC (NPI# 1689860629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689860629 |
| Entity Type | Organization |
| Organization Name | EVERGREEN FAMILY MEDICAL CLINIC INC |
| Practice Address |
4929 Highway 371 S Nettleton MS 38858-6901 |
| Practice Telephone | 6629639154 |
| Practice Fax Number | 6629639157 |
| Mailing Telephone | 6629639154 |
| Mailing Fax Number | 6629639157 |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2018-06-20 |
| Authorized Official Name | MRS. CYNTHIA JEANESSE RUSHING (CFNP/OWNER) |
| Authorized Official Telephone | 6629639154 |
| Authorized Official Credential | CFNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
========= | MS | Ambulatory Health Care Facilities |
| Street Address |
4929 HIGHWAY 371 S |
| City | NETTLETON |
| State | MS |
| Zip Code | 38858-6901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396763298 | Evergreen Clini | Nurse Practitioner | 4929 Highway 371 S, Nettleton, MS 38858-6901 | 2006-07-18 |
| 1841692852 | Family Care of Evergreen, LLC | Nurse Practitioner | 4929 Highway 371 S, Nettleton, MS 38858-6901 | 2014-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518500677 | Nettleton Medical Express Care LLC | General Practice | 7230 Highway 45 N Ste B, 32610 Hwy 45 N, Nettleton, MS 38858 | 2019-10-22 |
| 1467930537 | Michael Anthony Mcbryde | Physical Therapist | 230 Main St., Suite A, Nettleton, MS 38858 | 2018-08-01 |
| 1952813677 | Raquel Ziegler | Physical Therapist | 230-a Main St., Nettleton, MS 38858 | 2017-11-03 |
| 1386843050 | James Andrew Jackson | Dentist | 228 Main St., Nettleton, MS 38858 | 2007-07-13 |
| 1902925340 | John T Hall | Pharmacist | 174a Young Ave, Nettleton, MS 38858 | 2007-03-28 |
| 1063463677 | Sally Lawson Morgan | Nurse Practitioner | 182 W Main St, Nettleton, MS 38858 | 2006-05-16 |
| 1174591044 | Deborra Cassandra Lee | Counselor | 134 Morgan Circle, Nettleton, MS 38858 | 2006-03-08 |
| 1215913074 | Cynthia J Rushing | Nurse Practitioner | 4929 Hwy 351 S, Nettleton, MS 38858 | 2005-12-22 |
| 1295972644 | W. A. Thames, Dmd | Dentist | 228 Main Street, Box 388, Nettleton, MS 38858 | 2009-01-07 |
| 1386868719 | Nettleton Family Clinic | Family Medicine | 182 West Main St, Nettleton, MS 38858 | 2007-04-13 |
| Find all providers in zip 38858 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427612183 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 1495 Maple Rd, Nettleton, MS 38858-6026 | 2019-04-29 |
| 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 | ||||
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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.