| |
2124 14th St Meridian MS 39301-4040 | |
(601) 703-3480 | |
(601) 703-0124 |
Full Name | |
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Speciality | Clinic/Center |
Location | 2124 14th St, Meridian, Mississippi |
Authorized Official Name and Position | Gregory M Duckett (SR VP / CLO) |
Authorized Official Contact | 9012275233 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 2839 Meridian MS 39302-2839 Ph: (601) 703-3480 | 2124 14th St Meridian MS 39301-4040 Ph: (601) 703-3480 |
NPI Number | 1760798227 |
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Provider Enumeration Date | 08/23/2010 |
Last Update Date | 08/16/2024 |
Medicare PECOS PAC ID | 3274727318 |
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Medicare Enrollment ID | O20101102000877 |
Identifier | Type | State | Issuer |
---|---|---|---|
1760798227 | NPI | - | NPPES |
127195 | Medicaid | AL | |
03604849 | Medicaid | MS |
Provider Name | Randall Hicks |
---|---|
Provider Type | Practitioner - Nephrology |
Provider Identifiers | NPI Number: 1982600060 PECOS PAC ID: 1850294661 Enrollment ID: I20040129000556 |
Provider Name | Gary Gibson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1376520924 PECOS PAC ID: 2062301336 Enrollment ID: I20040313000693 |
Provider Name | Mohammad N Alfarawati |
---|---|
Provider Type | Practitioner - Pulmonary Disease |
Provider Identifiers | NPI Number: 1154582542 PECOS PAC ID: 9931193745 Enrollment ID: I20040414000151 |
Provider Name | Cameron Huxford |
---|---|
Provider Type | Practitioner - Pulmonary Disease |
Provider Identifiers | NPI Number: 1972671626 PECOS PAC ID: 0840280020 Enrollment ID: I20040518000779 |
Provider Name | Ronnye D Purvis |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1851495295 PECOS PAC ID: 8628044344 Enrollment ID: I20040903000602 |
Provider Name | Willie E Greer |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1922080522 PECOS PAC ID: 5799745881 Enrollment ID: I20041013000691 |
Provider Name | John C Andy |
---|---|
Provider Type | Practitioner - Nephrology |
Provider Identifiers | NPI Number: 1336126911 PECOS PAC ID: 9830155944 Enrollment ID: I20041209000402 |
Provider Name | Scott J Hanegan |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1407922867 PECOS PAC ID: 4183678022 Enrollment ID: I20050309000279 |
Provider Name | Leigh White |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1558437830 PECOS PAC ID: 0840244265 Enrollment ID: I20050309000327 |
Provider Name | William A Billups |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1598737215 PECOS PAC ID: 3173426368 Enrollment ID: I20050511000387 |
Provider Name | Kary G Whitehead |
---|---|
Provider Type | Practitioner - Sleep Medicine |
Provider Identifiers | NPI Number: 1215933924 PECOS PAC ID: 8123060944 Enrollment ID: I20050523000707 |
Provider Name | Otis Gowdy |
---|---|
Provider Type | Practitioner - Nephrology |
Provider Identifiers | NPI Number: 1992782544 PECOS PAC ID: 3678500592 Enrollment ID: I20050722000297 |
Provider Name | Muzaffar Rahat |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1336145762 PECOS PAC ID: 2062433253 Enrollment ID: I20051215000524 |
Provider Name | Richmond L Alexander Iii |
---|---|
Provider Type | Practitioner - Pulmonary Disease |
Provider Identifiers | NPI Number: 1336145770 PECOS PAC ID: 5597786798 Enrollment ID: I20051215000544 |
Provider Name | William G Thaggard |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1114923547 PECOS PAC ID: 4082619697 Enrollment ID: I20061003000229 |
Provider Name | Kent A Darsey |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1851396337 PECOS PAC ID: 6305841925 Enrollment ID: I20061003000364 |
Provider Name | Francis E Harman |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1245232495 PECOS PAC ID: 1759386378 Enrollment ID: I20061003000377 |
Provider Name | Mary A Ward |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821278813 PECOS PAC ID: 8729157839 Enrollment ID: I20080515000290 |
Provider Name | Douglas C Phillips |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1396740882 PECOS PAC ID: 3577632496 Enrollment ID: I20080519000560 |
Provider Name | Shawn Shawn Anderson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1003831397 PECOS PAC ID: 9335238898 Enrollment ID: I20080527000508 |
Provider Name | Anthony L Thomas |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1639156235 PECOS PAC ID: 0941370951 Enrollment ID: I20080603000597 |
Provider Name | William F Reid |
---|---|
Provider Type | Practitioner - Pulmonary Disease |
Provider Identifiers | NPI Number: 1760469340 PECOS PAC ID: 8123198132 Enrollment ID: I20080603000634 |
Provider Name | Robert E Clark |
---|---|
Provider Type | Practitioner - Nephrology |
Provider Identifiers | NPI Number: 1518944198 PECOS PAC ID: 9133299142 Enrollment ID: I20080604000046 |
Provider Name | Terry M French |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1255336749 PECOS PAC ID: 5597809350 Enrollment ID: I20100217000071 |
Provider Name | Zaineb Daud |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1568468908 PECOS PAC ID: 9234273756 Enrollment ID: I20100223000003 |
Provider Name | Thomas Barry Calvit |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1427031731 PECOS PAC ID: 0042342966 Enrollment ID: I20100713000173 |
Provider Name | Cynthia M Schuetz Smith |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043541337 PECOS PAC ID: 6002949880 Enrollment ID: I20100730000095 |
Provider Name | Marshall Scott Tynes |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1063509719 PECOS PAC ID: 9032297072 Enrollment ID: I20101004000758 |
Provider Name | Laura E Alexander |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1780881128 PECOS PAC ID: 6507058245 Enrollment ID: I20101013000255 |
Provider Name | Mark Theodore Phillips |
---|---|
Provider Type | Practitioner - Urology |
Provider Identifiers | NPI Number: 1821124728 PECOS PAC ID: 2163617531 Enrollment ID: I20101115000044 |
Provider Name | Daniel J Mckiever |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1174626303 PECOS PAC ID: 5294727335 Enrollment ID: I20101214000018 |
Provider Name | Daniel Denison |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1871637264 PECOS PAC ID: 3779771290 Enrollment ID: I20101228000951 |
Provider Name | Robert Eubanks |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1356504872 PECOS PAC ID: 1850569013 Enrollment ID: I20110714000554 |
Provider Name | Kenneth R Thomas |
---|---|
Provider Type | Practitioner - Urology |
Provider Identifiers | NPI Number: 1891900569 PECOS PAC ID: 6406025865 Enrollment ID: I20110802000142 |
Provider Name | Juantina M Johnson |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1285683342 PECOS PAC ID: 7618975871 Enrollment ID: I20110802000548 |
Provider Name | Valerie N Evans |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1396980116 PECOS PAC ID: 7315104056 Enrollment ID: I20120207000710 |
Provider Name | Heather D Bunyard |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164794178 PECOS PAC ID: 0446411169 Enrollment ID: I20120405000303 |
Provider Name | Lauren B Holmes |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679843544 PECOS PAC ID: 5890951073 Enrollment ID: I20120717000351 |
Provider Name | Silvia A Bevilacqua |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1558411207 PECOS PAC ID: 6507015427 Enrollment ID: I20121009000155 |
Provider Name | Casey C Tillery |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710227905 PECOS PAC ID: 1052551363 Enrollment ID: I20130710000475 |
Provider Name | Cindy R Patrick |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366877268 PECOS PAC ID: 0941435523 Enrollment ID: I20131107000678 |
Provider Name | Sarah D Anderson |
---|---|
Provider Type | Practitioner - Osteopathic Manipulative Medicine |
Provider Identifiers | NPI Number: 1912294224 PECOS PAC ID: 7517197403 Enrollment ID: I20140219001671 |
Provider Name | Rahmath U Begum |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1508170853 PECOS PAC ID: 1355572603 Enrollment ID: I20140329000148 |
Provider Name | Paula C Morgan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326460627 PECOS PAC ID: 8527191113 Enrollment ID: I20140513002107 |
Provider Name | Hans Hunt Tulip |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1639309925 PECOS PAC ID: 5597984344 Enrollment ID: I20140910000952 |
Provider Name | Ericka C Vaughn |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1598870032 PECOS PAC ID: 3274514906 Enrollment ID: I20141222001684 |
Provider Name | Sonia Rodriguez |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265806038 PECOS PAC ID: 3678873411 Enrollment ID: I20151130000775 |
Provider Name | Trenton J. Hughes |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356791982 PECOS PAC ID: 2466747506 Enrollment ID: I20160829000444 |
Provider Name | Niraj James Shah |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1235495474 PECOS PAC ID: 3678861853 Enrollment ID: I20161004002893 |
Provider Name | Amanda H Fowler |
---|---|
Provider Type | Practitioner - Rheumatology |
Provider Identifiers | NPI Number: 1215224886 PECOS PAC ID: 7911286059 Enrollment ID: I20161114001721 |
Provider Name | James Wallace |
---|---|
Provider Type | Practitioner - Urology |
Provider Identifiers | NPI Number: 1881794162 PECOS PAC ID: 2961474507 Enrollment ID: I20170717003393 |
Provider Name | Adam Nicholas Protos |
---|---|
Provider Type | Practitioner - Cardiac Surgery |
Provider Identifiers | NPI Number: 1629383922 PECOS PAC ID: 8325277007 Enrollment ID: I20170802001574 |
Provider Name | Felecia Brown |
---|---|
Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1598902447 PECOS PAC ID: 2769754407 Enrollment ID: I20170816000316 |
Provider Name | Sondra D Odom |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477073393 PECOS PAC ID: 2365709243 Enrollment ID: I20171130002784 |
Provider Name | Caleb Robert Dulaney |
---|---|
Provider Type | Practitioner - Radiation Oncology |
Provider Identifiers | NPI Number: 1437592276 PECOS PAC ID: 0840433983 Enrollment ID: I20180517000757 |
Provider Name | Stacy Blalock |
---|---|
Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1518325299 PECOS PAC ID: 8123373552 Enrollment ID: I20180626001393 |
Provider Name | Erin Cooley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730671538 PECOS PAC ID: 4688921133 Enrollment ID: I20180716001712 |
Provider Name | Shelley Creighton |
---|---|
Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1790207702 PECOS PAC ID: 6901156652 Enrollment ID: I20180830001912 |
Provider Name | Matthew T Coker |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1295145118 PECOS PAC ID: 6709129000 Enrollment ID: I20190529001685 |
Provider Name | Felecia Brown |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598902447 PECOS PAC ID: 2769754407 Enrollment ID: I20190823000667 |
Provider Name | Melissa Lynn Mcelhenney |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508403429 PECOS PAC ID: 5092140509 Enrollment ID: I20200110000177 |
Provider Name | Eric Edward Holt |
---|---|
Provider Type | Practitioner - Nephrology |
Provider Identifiers | NPI Number: 1013070424 PECOS PAC ID: 8325000854 Enrollment ID: I20201012001223 |
Provider Name | Ashok Kumar Coimbatore Jeyakumar |
---|---|
Provider Type | Practitioner - Thoracic Surgery |
Provider Identifiers | NPI Number: 1982127437 PECOS PAC ID: 2163753989 Enrollment ID: I20201028002711 |
Provider Name | Julie Smythe Harper |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720556319 PECOS PAC ID: 1355755018 Enrollment ID: I20210121000801 |
Provider Name | Emily Anders |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780286237 PECOS PAC ID: 8224438205 Enrollment ID: I20210614000228 |
Provider Name | Armie W Walker |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1780626762 PECOS PAC ID: 2466451828 Enrollment ID: I20210802000561 |
Provider Name | Kristi Warren Durgin |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1306086541 PECOS PAC ID: 3375932536 Enrollment ID: I20211110001616 |
Provider Name | Craig M Tilghman |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1174634448 PECOS PAC ID: 5294860631 Enrollment ID: I20220314001774 |
Provider Name | Kevin Hatcher |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952936213 PECOS PAC ID: 0446638860 Enrollment ID: I20220525002303 |
Provider Name | Athanasios Tsiouris |
---|---|
Provider Type | Practitioner - Cardiac Surgery |
Provider Identifiers | NPI Number: 1336370576 PECOS PAC ID: 8224260716 Enrollment ID: I20221017000720 |
Provider Name | Margaret Doggett Nelson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326751678 PECOS PAC ID: 7517339534 Enrollment ID: I20230220002260 |
Provider Name | David Lott |
---|---|
Provider Type | Practitioner - Endocrinology |
Provider Identifiers | NPI Number: 1558859884 PECOS PAC ID: 2961751904 Enrollment ID: I20230509001402 |
Provider Name | Stephanie Hatcher |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629759410 PECOS PAC ID: 4082060454 Enrollment ID: I20231023001022 |
Provider Name | Krystal Chantal Trussell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417731548 PECOS PAC ID: 5698124352 Enrollment ID: I20231207000994 |
Provider Name | Jamie M Thrash |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861123739 PECOS PAC ID: 1254776792 Enrollment ID: I20240223003521 |
Provider Name | Mark Jospeh Yockey |
---|---|
Provider Type | Practitioner - Urology |
Provider Identifiers | NPI Number: 1326239203 PECOS PAC ID: 7517137417 Enrollment ID: I20240423002052 |
Provider Name | Thomas Hunter Mcmullen |
---|---|
Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1053872580 PECOS PAC ID: 5799016721 Enrollment ID: I20240807002799 |
Provider Name | Robert Wood |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1932762598 PECOS PAC ID: 5395076087 Enrollment ID: I20241014000067 |
Provider Name | Kelsey Bounds Wood |
---|---|
Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1477014983 PECOS PAC ID: 6103258587 Enrollment ID: I20241019000194 |
Provider Name | Gina Elizabeth Gunter |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154077063 PECOS PAC ID: 3779019781 Enrollment ID: I20241212004006 |
Greater Meridian Health Clinic, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2701 Davis St, Meridian, MS 39301 Phone: 601-693-0118 Fax: 844-778-8922 | |
Greater Meridian Health Clinic, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2701 Davis St, Meridian, MS 39301 Phone: 601-693-0118 Fax: 844-778-8922 | |
Primary Medical Services Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5000 Highway 39 N, Meridian, MS 39301 Phone: 601-646-0898 | |