| Ccfhc | |
|
2045 Highway 61 North Port Gibson MS 39150-4262 | |
| (601) 437-3049 | |
| (601) 437-3051 |
| Full Name | Ccfhc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2045 Highway 61 North, Port Gibson, Mississippi |
| Authorized Official Name and Position | Ladonna Beasley Davis (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 6014373052 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ccfhc 2045 Highway 61 N P O Box 741 Port Gibson MS 39150-4262 Ph: (601) 437-3049 | Ccfhc 2045 Highway 61 North Port Gibson MS 39150-4262 Ph: (601) 437-3049 |
| NPI Number | 1235133968 |
|---|---|
| Provider Enumeration Date | 06/10/2005 |
| Last Update Date | 09/24/2013 |
| Medicare PECOS PAC ID | 3072412105 |
|---|---|
| Medicare Enrollment ID | O20040107000639 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235133968 | NPI | - | NPPES |
| 09010054 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Mississippi) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Marvell Spears |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548365901 PECOS PAC ID: 2466351457 Enrollment ID: I20040108000414 |
| Provider Name | Charlene D King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104851161 PECOS PAC ID: 6901861574 Enrollment ID: I20041123000198 |
| Provider Name | Mheja M Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811050594 PECOS PAC ID: 0840392635 Enrollment ID: I20070226000269 |
| Provider Name | Arlene Hunt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659721116 PECOS PAC ID: 5597043018 Enrollment ID: I20161103000140 |
| Provider Name | Brenda Faye Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861930851 PECOS PAC ID: 1850677485 Enrollment ID: I20170417000511 |
| Provider Name | Hazel M Washington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497272041 PECOS PAC ID: 7214281369 Enrollment ID: I20181108002083 |
| Provider Name | Ursula Brooks-clemons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558727560 PECOS PAC ID: 2365748670 Enrollment ID: I20190528000223 |
| Provider Name | Jacqueline Curtis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700461456 PECOS PAC ID: 0547660201 Enrollment ID: I20210617000168 |
Claiborne County Medical Center Rural Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 123 Mccomb Ave, Port Gibson, MS 39150 Phone: 601-437-5141 Fax: 601-437-3782 | |
Port Gibson Middle School Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 161 Ramsey Dr, Port Gibson, MS 39150 Phone: 601-437-4251 | |
A W Watson Elementary School Base Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 880 Anthony St, 2045 Highway 61 North, Port Gibson, MS 39150 Phone: 601-437-0257 Fax: 601-437-3944 | |
Claiborne County Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 123 Mccomb Ave, Port Gibson, MS 39150 Phone: 601-437-5141 Fax: 601-437-5130 | |
Family Wellness Clinic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 703b Farmer St, Port Gibson, MS 39150 Phone: 601-437-5668 Fax: 601-437-4533 | |
Patients Choice Medical Center Of Claiborne County Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 123 Mccomb Ave, Port Gibson, MS 39150 Phone: 601-437-5141 Fax: 601-437-3782 |