MALLORY COMMUNITY HEALTH (NPI# 1740624881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740624881 |
| Entity Type | Organization |
| Organization Name | MALLORY COMMUNITY HEALTH |
| Other Organization Name | DR. ARENIA C. MALLORY COMMUNITY HEALTH CENTER, INC. |
| Practice Address |
300 Yazoo Street Lexington MS 39095 |
| Mailing Address |
Post Office Box 479 Lexington MS 39095-0479 |
| Practice Telephone | 6628345000 |
| Practice Fax Number | 6628345003 |
| Mailing Telephone | 6628341857 |
| Mailing Fax Number | 6628344937 |
| Enumeration Date | 2013-04-19 |
| Last Update Date | 2016-07-21 |
| Authorized Official Name | MR. CLYDE ROZELL CHAPMAN (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6628341857 |
| Authorized Official Credential | MD |
| 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 | 00474061 | 05 |
| Other Name | Type Code |
|---|---|
| Dr. Arenia C. Mallory Community Health Center, Inc. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104348606 | Mallory Community Health | Clinic/Center | 9479 Brozville Rd, Lexington, MS 39095-7090 | 2017-07-17 |
| 1295282358 | Mallory Community Health | Clinic/Center | 9749 Brozville Road, Lexington, MS 39095 | 2016-09-07 |
| 1477009876 | Mallory Community Health | Clinic/Center | 14494 Highway 51, Durant, MS 39063-9627 | 2016-08-27 |
| 1427504943 | Mallory Community Health | Clinic/Center | 12572 Highway 12, Lexington, MS 39095-8036 | 2016-08-26 |
| 1104279355 | Mallory Community Health | Clinic/Center | 3877 Highway 51, Goodman, MS 39079-9588 | 2016-07-22 |
| 1053649749 | Mallory Community Health | Clinic/Center | 201 East Washington Street, Greenwood, MS 38930 | 2009-11-18 |
| 1053439133 | Mallory Community Health | Clinic/Center | 201a Magnolia St, Vaiden, MS 39176-5644 | 2007-03-27 |
| 1881713519 | Mallory Community Health | Clinic/Center | 9715 Highway 12 W, Tchula, MS 39169 | 2007-03-27 |
| 1902923527 | Mallory Community Health | Clinic/Center | 33795 Highway 12 East, Durant, MS 39063 | 2007-03-26 |
| 1013034636 | Mallory Community Health | Clinic/Center | 276 Nissan Parkway, Building C, Suite 100, Canton, MS 39046 | 2007-03-26 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MALLORY COMMUNITY HEALTH CENTER | 17280 Highway 17 South, Lexington, MS 39095-6614 |
| Street Address |
300 YAZOO STREET |
| City | LEXINGTON |
| State | MS |
| Zip Code | 39095 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295282358 | Mallory Community Health | Clinic/Center | 9749 Brozville Road, Lexington, MS 39095 | 2016-09-07 |
| 1336596170 | Telehealthone, LLC | Nurse Practitioner | 301 Yazoo Street, Lexington, MS 39095 | 2016-05-23 |
| 1912245671 | Ciera N Draine | Social Worker | Dr Arenia C Mallory Community Health Center, 17280 Highway 17 S, Lexington, MS 39095 | 2013-01-30 |
| 1184933384 | John D. Whitehead | Durable Medical Equipment & Medical Supplies | 22743 Hwy 12, Lexington, MS 39095 | 2010-10-05 |
| 1942536552 | Durant Primary Care Clinic | Clinic/Center | 22741 Bowling Green Rd, Lexington, MS 39095 | 2009-11-02 |
| 1205082963 | Heather Killebrew Tutor, Dmd, Pa | Dentist | 302 Court Square, Lexington, MS 39095 | 2008-08-13 |
| 1023145430 | Charles D Howard | Dentist | 102 Wall St, Lexington, MS 39095 | 2007-02-27 |
| 1619069622 | Charles Walton Campbell | Family Medicine | 102 Carrollton St, Lexington, MS 39095 | 2006-09-28 |
| 1972617876 | Lexington Primary Care | Clinic/Center | 110 Tchula Street, Lexington Primary Care, Lexington, MS 39095 | 2006-08-18 |
| 1477563427 | State of Mississippi - University of Mississippi Medical Center | General Acute Care Hospital | 239 Bowling Green Road, Lexington, MS 39095 | 2006-08-09 |
| Find all providers in zip 39095 | ||||
| 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 |
|---|---|---|---|---|
| 1295356731 | Health Care Coalition of Lafayette County | Clinic/Center | 811 S Business Highway 13, Lexington, MO 64067-1515 | 2020-05-06 |
| 1104348606 | Mallory Community Health | Clinic/Center | 9479 Brozville Rd, Lexington, MS 39095-7090 | 2017-07-17 |
| 1295282358 | Mallory Community Health | Clinic/Center | 9749 Brozville Road, Lexington, MS 39095 | 2016-09-07 |
| 1427504943 | Mallory Community Health | Clinic/Center | 12572 Highway 12, Lexington, MS 39095-8036 | 2016-08-26 |
| 1982002549 | Samuel U. Rodgers Health Center, Inc | Clinic/Center | 2309 Aull Ln, Lexington, MO 64067 | 2014-12-15 |
| 1831386192 | Eastern Kentucky University | Clinic/Center | 151 N Eagle Creek, Suite 220, Lexington, KY 40509-1892 | 2007-10-01 |
| 1164614053 | Samuel U. Rodgers Health Center, Inc. | Clinic/Center | 811 S Business Highway 13 Ste A, Lexington, MO 64067 | 2007-08-14 |
| 1164460051 | Eastern Kentucky University | Clinic/Center | 1306 Versailles Rd, Suite 120, Lexington, KY 40504-1117 | 2006-06-03 |
| 1053951756 | Gaston Family Health Services, Inc | Clinic/Center | 32 Kirkwood Ave, Lexington, NC 27292-4024 | 2020-01-10 |
| 1992343206 | Healthfirst Bluegrass Inc. | Clinic/Center | 350 N Limestone, Lexington, KY 40508-1871 | 2019-12-17 |
| Find all providers in LEXINGTON | ||||
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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.