Caretime Medical Clinic, Llc | |
1506 Highway 278 E Ste A Amory MS 38821-5906 | |
(662) 597-2019 | |
Not Available |
Full Name | Caretime Medical Clinic, Llc |
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Speciality | Family Medicine |
Location | 1506 Highway 278 E Ste A, Amory, Mississippi |
Authorized Official Name and Position | Shannon Leianne Ballard (OWNER) |
Authorized Official Contact | 6625972019 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Caretime Medical Clinic, Llc 1506 Highway 278 E Ste A Amory MS 38821-5906 Ph: (662) 597-2019 | Caretime Medical Clinic, Llc 1506 Highway 278 E Ste A Amory MS 38821-5906 Ph: (662) 597-2019 |
NPI Number | 1700247855 |
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Provider Enumeration Date | 03/17/2016 |
Last Update Date | 04/28/2016 |
Medicare PECOS PAC ID | 4587953096 |
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Medicare Enrollment ID | O20160523000504 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700247855 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Clinton L Washington |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1437163763 PECOS PAC ID: 3173530698 Enrollment ID: I20060308000518 |
Provider Name | Laura L Washington |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1093721151 PECOS PAC ID: 1254348774 Enrollment ID: I20060308000537 |
Provider Name | Shannon L Ballard |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275836991 PECOS PAC ID: 3779750948 Enrollment ID: I20120111000978 |
Provider Name | Elaina Ponder |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235783127 PECOS PAC ID: 2062839814 Enrollment ID: I20200825003861 |
Provider Name | Carl Andrew Ballard |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386243574 PECOS PAC ID: 3577971019 Enrollment ID: I20210421001587 |
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