Crystal Springs Clinic - Medicare Primary Care in Crystal Springs, MS

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Crystal Springs Clinic is a medicare enrolled primary clinic (Family Medicine) in Crystal Springs, Mississippi. The current practice location for Crystal Springs Clinic is 123 Bo Bo Dr, Crystal Springs, Mississippi. For appointments, you can reach them via phone at (601) 892-1456. The mailing address for Crystal Springs Clinic is 27190 Hwy 28, Hazlehurst, Mississippi and phone number is (601) 574-7200.

Crystal Springs Clinic is licensed to practice in Mississippi (license number ). The clinic also participates in the medicare program and its NPI number is 1972603819. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (601) 892-1456.

Contact Information

Crystal Springs Clinic
123 Bo Bo Dr
Crystal Springs
MS 39059
(601) 892-1456
(601) 892-1456

Map and Direction


Primary Care Clinic Profile

Full NameCrystal Springs Clinic
SpecialityFamily Medicine
Location123 Bo Bo Dr, Crystal Springs, Mississippi
Authorized Official Name and PositionKortney M. Gaddy (CFO)
Authorized Official Contact6015747200
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Crystal Springs Clinic
27190 Hwy 28
Hazlehurst
MS 39083

Ph: (601) 574-7200		Crystal Springs Clinic
123 Bo Bo Dr
Crystal Springs
MS 39059

Ph: (601) 892-1456

NPI Details:

NPI Number1972603819
Provider Enumeration Date09/22/2006
Last Update Date09/22/2022

Medicare PECOS Information:

Medicare PECOS PAC ID3577569862
Medicare Enrollment IDO20080714000378

Medical Identifiers

Medical identifiers for Crystal Springs Clinic such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1972603819NPI-NPPES
09014049MedicaidMS
00116996MedicaidMS
00012939MedicaidMS
00015329MedicaidMS
00011981MedicaidMS
00113908MedicaidMS
00119484MedicaidMS
00122024MedicaidMS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (Mississippi)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Crystal Springs Clinic acts as a billing entity for following providers:
Provider NameRandall R Hankins
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1235231606
PECOS PAC ID: 1052384732
Enrollment ID: I20040819000841
Provider NameRobert L Walker
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1649216680
PECOS PAC ID: 4981672623
Enrollment ID: I20040921000682
Provider NameKenneth J Whittington
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1679514863
PECOS PAC ID: 7517905656
Enrollment ID: I20050420000290
Provider NameRobert W Watson
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1669413233
PECOS PAC ID: 5294762373
Enrollment ID: I20050720000566
Provider NameFred J Mcdonnell
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1891897260
PECOS PAC ID: 1759387053
Enrollment ID: I20080725000422
Provider NamePreston B Mcdonnell
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1285863886
PECOS PAC ID: 9739344672
Enrollment ID: I20120627000636
Provider NameKaren Boone
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1144762568
PECOS PAC ID: 6002193927
Enrollment ID: I20170502002472
Provider NameWilliam Shaw
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1316450125
PECOS PAC ID: 9234493313
Enrollment ID: I20180426001906
Provider NameChristopher J Price
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1740767920
PECOS PAC ID: 1456601145
Enrollment ID: I20180829003739
Provider NameLauren E Thompson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1285129833
PECOS PAC ID: 4082965504
Enrollment ID: I20180924000305

Reviews and Comments


Family Medicine in Crystal Springs, MS

Family Medical Clinic Of Crystal Springs Pllc
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 104 W Railroad Ave S, Crystal Springs, MS 39059
Phone: 601-892-3063    Fax: 601-892-3570
Robert A. Gannaway, M.d., Pllc
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 408 E Railroad Ave, Suite B, Crystal Springs, MS 39059
Phone: 601-892-7860    Fax: 601-892-7861

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.