Dr. Arenia C. Mallory Community Health Center, Inc. | |
17280 Highway 17 South Lexington MS 39095 | |
(662) 834-1857 | |
(662) 834-4937 |
Full Name | Dr. Arenia C. Mallory Community Health Center, Inc. |
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Speciality | Clinic/Center |
Location | 17280 Highway 17 South, Lexington, Mississippi |
Authorized Official Name and Position | Clyde Rozell Chapman (INTERIM CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 6628341857 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dr. Arenia C. Mallory Community Health Center, Inc. Po Box 479 Lexington MS 39095-0479 Ph: (662) 834-1857 | Dr. Arenia C. Mallory Community Health Center, Inc. 17280 Highway 17 South Lexington MS 39095 Ph: (662) 834-1857 |
NPI Number | 1740308873 |
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Provider Enumeration Date | 03/27/2007 |
Last Update Date | 07/29/2015 |
Medicare PECOS PAC ID | 9739074501 |
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Medicare Enrollment ID | O20040219000709 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740308873 | NPI | - | NPPES |
09013975 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Provider Name | Teresa Ann Raybourn |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992782304 PECOS PAC ID: 0244289528 Enrollment ID: I20050113000268 |
Provider Name | Renita F Cotton |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1902832538 PECOS PAC ID: 7618990672 Enrollment ID: I20060105000593 |
Provider Name | Katherine Hughes |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326079047 PECOS PAC ID: 4385640994 Enrollment ID: I20061004000461 |
Provider Name | Keith I Stokes |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1821297961 PECOS PAC ID: 8628148780 Enrollment ID: I20080531000013 |
Provider Name | Romero K Midgett |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1598903577 PECOS PAC ID: 0648336131 Enrollment ID: I20090309000257 |
Provider Name | Nadean Randle |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1851548135 PECOS PAC ID: 9830255058 Enrollment ID: I20090312000520 |
Provider Name | Harsh Doshi |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1831150531 PECOS PAC ID: 6204992472 Enrollment ID: I20090313000150 |
Provider Name | Jill Shaw |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457508475 PECOS PAC ID: 7113074287 Enrollment ID: I20100329001034 |
Provider Name | Katrina Cotton |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780935841 PECOS PAC ID: 1850531815 Enrollment ID: I20130716000131 |
Provider Name | Erin K Hines |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952742736 PECOS PAC ID: 3779712799 Enrollment ID: I20140214000449 |
Provider Name | Keila L Brown |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518380120 PECOS PAC ID: 8628291663 Enrollment ID: I20140521000600 |
Provider Name | Anita Greer |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780087304 PECOS PAC ID: 3274858345 Enrollment ID: I20150212000310 |
Provider Name | Kristie Lashundra Anderson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447632351 PECOS PAC ID: 1658680640 Enrollment ID: I20151013002158 |
Provider Name | Clyde Rozell Chapman |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1952630089 PECOS PAC ID: 8527373489 Enrollment ID: I20160113000248 |
Provider Name | Monique D Pendleton |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497147318 PECOS PAC ID: 0840593679 Enrollment ID: I20160128000223 |
Provider Name | Dana Roberts |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457706913 PECOS PAC ID: 0941591929 Enrollment ID: I20160622001329 |
Provider Name | Lease Wordlaw |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1578923454 PECOS PAC ID: 6406131556 Enrollment ID: I20170403000414 |
Provider Name | Melissa Yvonne White |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033643432 PECOS PAC ID: 7618246752 Enrollment ID: I20170816002914 |
Provider Name | Michele L Brooks |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467976548 PECOS PAC ID: 9234403536 Enrollment ID: I20170926001590 |
Provider Name | Kathryn Conner Carroll |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093226763 PECOS PAC ID: 5991061319 Enrollment ID: I20171117000055 |
Provider Name | Sharon Mcmillin |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558872663 PECOS PAC ID: 5092071456 Enrollment ID: I20171117002070 |
Provider Name | Trevalla Kaye Lindsey |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538697453 PECOS PAC ID: 8820356843 Enrollment ID: I20171221001211 |
Provider Name | Monica L Williams |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962875575 PECOS PAC ID: 7113286725 Enrollment ID: I20180104001772 |
Provider Name | Ciera N Draine |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1912245671 PECOS PAC ID: 0648578419 Enrollment ID: I20181002000435 |
Provider Name | Tammie Marshell Brown |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902362734 PECOS PAC ID: 5799027884 Enrollment ID: I20190418002391 |
Provider Name | Jenna Brooke Pugh |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124660063 PECOS PAC ID: 1254764830 Enrollment ID: I20191212002109 |
Provider Name | Kevin Patterson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356999460 PECOS PAC ID: 4981038700 Enrollment ID: I20200102000684 |
Provider Name | Melanie Bernita Eiland |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265015028 PECOS PAC ID: 2466857859 Enrollment ID: I20210824000227 |
Provider Name | Orlesha Carroll Bishop |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629578273 PECOS PAC ID: 5799174538 Enrollment ID: I20211116001881 |
Provider Name | X'zanthea Terrineca Scott |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447821186 PECOS PAC ID: 7517357403 Enrollment ID: I20211208002439 |
Provider Name | Jocelyn Patrice Seawood |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013699057 PECOS PAC ID: 8123480662 Enrollment ID: I20231206000547 |
Patients Choice Clinic Of Lexington Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 22741 Highway 12, Lexington, MS 39095 Phone: 662-834-1961 Fax: 662-834-1962 | |
Dr. Arenia C. Mallory Community Health Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9479 Brozville Rd, Lexington, MS 39095 Phone: 662-834-0532 | |
Mallory Community Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17280 Highway 17, Lexington, MS 39095 Phone: 662-834-1857 Fax: 662-834-1859 | |
Dr. Arenia C. Mallory Community Health Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9749 Brozville Road, Lexington, MS 39095 Phone: 662-834-2172 | |
Dr. Arenia C. Mallory Community Health Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12572 Highway 12, Lexington, MS 39095 Phone: 662-235-5226 | |
Mchc-hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17280 Highway 17, Lexington, MS 39095 Phone: 662-834-1857 Fax: 662-834-0531 | |
Mallory Mobile Rv Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 17280 Highway 17, Lexington, MS 39095 Phone: 662-834-1857 Fax: 662-834-1859 |