EAST CENTRAL MISSISSIPPI HEALTH CARE INC (NPI# 1699721209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699721209 |
| Entity Type | Organization |
| Organization Name | EAST CENTRAL MISSISSIPPI HEALTH CARE INC |
| Other Organization Name | SEBASTOPOL CLINIC |
| Practice Address |
1488 Hwy 487 Sebastopol MS 39359 |
| Mailing Address |
Po Box 142 Sebastopol MS 39359 |
| Practice Telephone | 6016257140 |
| Practice Fax Number | 6016257199 |
| Mailing Telephone | 6016257140 |
| Mailing Fax Number | 6016257199 |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | TAMMY L MCPHAIL (MIS INSURANCE COORDINATOR) |
| Authorized Official Telephone | 6016257140 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09010024 | 05 | |
| RAILROAD MEDICARE | DA1146 | 01 |
| Other Name | Type Code |
|---|---|
| Sebastopol Clinic | Doing Business As Name - Organization |
| Street Address |
1488 HWY 487 |
| City | SEBASTOPOL |
| State | MS |
| Zip Code | 39359 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730178161 | William A Mullendore | Family Medicine | 1488 Hwy 487, Sebastopol, MS 39359 | 2005-10-18 |
| 1881241123 | Mary Rose Thomas | Nurse Practitioner | 1488 Hwy 487, Sebastopol, MS 39359 | 2019-08-21 |
| 1790129021 | Benita Joetta Myles | Family Medicine | 1488 Hwy 487, Family Medicine, Sebastopol, MS 39359-0150 | 2013-04-17 |
| 1659626687 | Nicholas John Dennery II | Dentist | 1488 Hwy 487, Sebastopol, MS 39359-0150 | 2012-07-16 |
| 1851570006 | Telitha K Grant-spencer | Internal Medicine | 1488 Hwy 487, Sebastopol, MS 39359-0150 | 2007-10-24 |
| 1124232806 | James E. Yelverton | Dentist | 1488 Hwy 487, Sebastopol, MS 39359 | 2007-05-10 |
| 1932135522 | John Edwin Witcher | Emergency Medicine | 1488 Hwy 487, Sebastopol Clinic, Sebastopol, MS 39359 | 2006-06-24 |
| 1386621233 | Aser M Kandil | Pediatrics | 1488 Hwy 487, Sebastopol, MS 39359 | 2005-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942839881 | Shanna Donald | Social Worker | 32 Underwood Street, Sebastopol, MS 39359 | 2020-04-03 |
| 1891189114 | Reathia Sue Summers | Nurse Practitioner | 157 Hwy 492, Sebastopol, MS 39359 | 2015-03-25 |
| 1053524009 | Rodney L Moore | Pharmacy | 16831 Hwy 21 S, Sebastopol, MS 39359 | 2007-05-07 |
| 1427127018 | Malinda Elizabeth Ellis Gilmer | Registered Nurse | 32 Underwood St, Sebastopol, MS 39359 | 2006-11-07 |
| 1609853647 | Karen Reece | Nurse Practitioner | 1488 Highway 487, Sebastopol, MS 39359 | 2005-12-30 |
| 1760778609 | Independent Healthcare Management, Inc. | Clinic/Center | 17509 Hwy 21, Sebastopol, MS 39359-0000 | 2011-06-20 |
| 1730340563 | Kayti A Powell | Nurse Practitioner | 1488 Hwy 487 East, Sebastopol, MS 39359-0150 | 2008-06-24 |
| 1205355781 | Gaydon Nowell | Nurse Practitioner | 1488 Hwy 487 East, Sebastopol, MS 39359-0150 | 2017-09-15 |
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861809501 | West County Health Centers, Inc. | Clinic/Center | 652 Petaluma Ave, Sebastopol, CA 95472-4256 | 2014-07-15 |
| 1538334065 | West County Health Centers, Inc. | Clinic/Center | 6800 Palm Ave, Suite C2, Sebastopol, CA 95472-4269 | 2008-04-25 |
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|---|---|---|---|---|
| 1871193722 | Coastal Family Health Center, Inc | Clinic/Center | 12424 Highway 57, Vancleave, MS 39565-8608 | 2020-10-29 |
| 1992305445 | Coastal Family Health Center, Inc | Clinic/Center | 5500 Hurley Wade Rd, Moss Point, MS 39562-8548 | 2020-10-26 |
| 1841890399 | Coastal Family Health Center, Inc | Clinic/Center | 10700 Yellow Jacket Rd, Ocean Springs, MS 39564-8038 | 2020-10-26 |
| 1033755343 | Access Family Health Services, Inc. | Clinic/Center | 179 Mullen Ave, Nettleton, MS 38858-6033 | 2019-11-21 |
| 1285280180 | Delta Health Center, Inc | Clinic/Center | 506 Washington Avenue, Moorhead, MS 38761 | 2019-08-15 |
| 1265088421 | Delta Health Center, Inc | Clinic/Center | 400 South Blvd, Drew, MS 38737-3508 | 2019-08-14 |
| 1215583356 | Delta Health Center, Inc. | Clinic/Center | 302 College Ave, Indianola, MS 38751-2112 | 2019-08-14 |
| 1063068252 | Delta Health Center, Inc | Clinic/Center | 1101 Oak St, Inverness, MS 38753-8725 | 2019-08-13 |
| 1750937959 | Delta Health Center, Inc | Clinic/Center | 212 E Claiborne St, Sunflower, MS 38778-9640 | 2019-08-13 |
| 1750937108 | Delta Health Center, Inc | Clinic/Center | 410 L F Packer Dr, Ruleville, MS 38771-3604 | 2019-08-12 |
| Find all providers with the same taxonomy | ||||
| City | SEBASTOPOL |
| Zip Code | 39359 |
Please comment or provide details below to improve the information on EAST CENTRAL MISSISSIPPI HEALTH CARE INC.
| 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.