INDEPENDENT HEALTHCARE MANAGEMENT, INC. (NPI# 1760778609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760778609 |
| Entity Type | Organization |
| Organization Name | INDEPENDENT HEALTHCARE MANAGEMENT, INC. |
| Other Organization Name | MAIN STREET MEDICAL CLINIC OF SEBASTOPOL |
| Practice Address |
17509 Hwy 21 Sebastopol MS 39359-0000 |
| Practice Telephone | 6016259818 |
| Practice Fax Number | 6016259904 |
| Mailing Telephone | 6016259818 |
| Mailing Fax Number | 6016259904 |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2014-12-18 |
| Authorized Official Name | JOSEPH S MCNULTY III (CEO) |
| Authorized Official Telephone | 6018496440 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Main Street Medical Clinic of Sebastopol | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427500958 | Independent Healthcare Management, Inc. | Family Medicine | 1123 Highway 35 S Ste 3, Forest, MS 39074-8829 | 2016-11-01 |
| 1396118378 | Independent Healthcare Management, Inc. | Clinic/Center | 9427 Eastside Drive Ext, Suite A, Newton, MS 39345-8063 | 2015-11-12 |
| 1154670719 | Independent Healthcare Management, Inc. | Clinic/Center | 1129 Highway 35 S, Suite 1, Forest, MS 39074-8829 | 2012-08-29 |
| 1952694994 | Independent Healthcare Management, Inc. | Clinic/Center | 347 S 4th St, Morton, MS 39117-3407 | 2011-05-24 |
| 1245489186 | Independent Healthcare Management, Inc. | Clinic/Center | 526 Deerfield Dr, Suite C, Forest, MS 39074-6005 | 2008-09-16 |
| 1285956334 | Independent Healthcare Management, Inc. | Nurse Anesthetist, Certified Registered | 330 N Broad St, Forest, MS 39074-3508 | 2010-02-17 |
| 1306909734 | Independent Healthcare Management, Inc. | General Acute Care Hospital | 330 N Broad St, Forest, MS 39074-3508 | 2006-12-18 |
| 1255376729 | Independent Healthcare Management, Inc. | Clinic/Center | 330 N Broad St, Forest, MS 39074-3508 | 2006-06-18 |
| Street Address |
17509 HWY 21 |
| City | SEBASTOPOL |
| State | MS |
| Zip Code | 39359-0000 |
| 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 |
| 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 |
| 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 |
| 1699721209 | East Central Mississippi Health Care Inc | Clinic/Center | 1488 Hwy 487, Sebastopol, MS 39359 | 2006-05-25 |
| Find all providers in zip 39359 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| 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 | SEBASTOPOL |
| Zip Code | 39359 |
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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.