INDEPENDENT PHYSICIANS GROUP INC (NPI# 1790316214) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790316214 |
| Entity Type | Organization |
| Organization Name | INDEPENDENT PHYSICIANS GROUP INC |
| Other Organization Name | IPG INC |
| Practice Address |
870 Main St Fayette MS 39069-5695 |
| Mailing Address |
Po Box 27 Canton MS 39046-0027 |
| Practice Telephone | 6017863401 |
| Mailing Telephone | 6018325548 |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2020-06-28 |
| Authorized Official Name | WILLIAM TRULY (MANAGER/CEO) |
| Authorized Official Telephone | 6018290018 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QE0002X |
Clinic/Center Specialization: Emergency Care |
Ambulatory Health Care Facilities | ||
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities | ||
| N | 273R00000X | Psychiatric Unit | Hospital Units | ||
| N | 282NR1301X |
General Acute Care Hospital Specialization: Rural |
Hospitals | ||
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 03604223 | 05 |
| Other Name | Type Code |
|---|---|
| IPG Inc | Doing Business As Name - Organization |
| Street Address |
870 MAIN ST |
| City | FAYETTE |
| State | MS |
| Zip Code | 39069-5695 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083242390 | India Martin | Nurse Practitioner | 870 Main St, Fayette, MS 39069-5695 | 2020-03-31 |
| 1831656354 | Bounds Family Medical | Family Medicine | 870 Main St, Fayette, MS 39069-5695 | 2019-02-21 |
| 1295273670 | Matthew Kevin Bounds | Nurse Practitioner | 870 Main St, Fayette, MS 39069-5695 | 2017-02-06 |
| 1386018083 | Jefferson County Hospital | Psychiatric Unit | 870 Main St, Fayette, MS 39069-5695 | 2015-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265063135 | Georgene Ferrie | Massage Therapist | 1612 Main St., Fayette, MS 39069 | 2020-01-30 |
| 1942741764 | Prime Health and Wellness | Nurse Practitioner | 300 Shannon Street, Fayette, MS 39069 | 2017-03-13 |
| 1063967768 | P-cares Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 3476 River Road, Box 1055, Fayette, MS 39069 | 2016-08-23 |
| 1669866331 | Kanayo Ugboaja | Contractor | 157 Hicks St, Fayette, MS 39069 | 2015-03-20 |
| 1053666503 | Valerie Michele White | Nurse Practitioner | 225 Community Dr., Fayette, MS 39069 | 2012-07-20 |
| 1265752356 | John Ellis Evans | Family Medicine | 456 River Road, Fayette, MS 39069 | 2010-06-11 |
| 1922271691 | Jefferson Comprehensive Health Center Inc | Clinic/Center | Route 1 Box 266, Fayette, MS 39069 | 2008-04-02 |
| 1225247505 | Jefferson County Hospital | Family Medicine | 870 Main Street, Fayette, MS 39069 | 2007-05-22 |
| 1356410229 | Johnny B Bills | Family Medicine | 225 Community Ave, Fayette, MS 39069 | 2006-11-07 |
| 1962583971 | Priscilla Jackson | Nurse Practitioner | 225 Community Drive, Fayette, MS 39069 | 2006-10-17 |
| Find all providers in zip 39069 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568603330 | Charmaine Lillian Mccleave | Emergency Medicine | 69 Jackson Rd, Hattiesburg, MS 39402 | 2009-03-09 |
| 1144344151 | David L. Merideth | Emergency Medicine | 407b W Parkway Pl, Ridgeland, MS 39157-6031 | 2007-03-16 |
| 1184755308 | Amy B Davis | Emergency Medicine | 121 Pratt Dr Ste 1a, Corinth, MS 38834-6026 | 2007-03-08 |
| 1114087483 | David Butler Johnson | Emergency Medicine | 806 Crestview Dr, Yazoo City, MS 39194-2511 | 2006-12-09 |
| 1952323073 | Pratt Family Medical Clinic, P.a. | Emergency Medicine | 121 Pratt Drive, Suite 1 A, Corinth, MS 38834 | 2006-07-25 |
| 1730106600 | Sean Brian Appleyard | Emergency Medicine | Hancock Medical Center--emergency Dept, 149 Drink Water Blvd, Bay St. Loois, MS 39520 | 2006-07-16 |
| 1699703389 | Lisa D Anderson | Emergency Medicine | 935 Highway 51, Madison, MS 39110-8407 | 2006-06-29 |
| 1265486450 | Emmanuel Kpabitey | Emergency Medicine | 110 Yazoo Ave Ste 121, Clarksdale, MS 38614-4397 | 2006-05-20 |
| 1184614984 | Harvie D Harrier | Emergency Medicine | 114 E Percy St, Bed On The Bayou Cottage B, Indianola, MS 38751-2443 | 2005-10-24 |
| 1669904058 | Daniel Krebs | Emergency Medicine | 2809 Denny Ave, Pascagoula, MS 39581-5301 | 2017-04-03 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on INDEPENDENT PHYSICIANS GROUP 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.