Ellisville Medical Clinic - Medicare Primary Care in Ellisville, MS

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Ellisville Medical Clinic is a medicare enrolled primary clinic (Family Medicine) in Ellisville, Mississippi. The current practice location for Ellisville Medical Clinic is 1203 Avenue B, Ellisville, Mississippi. For appointments, you can reach them via phone at (601) 477-8553. The mailing address for Ellisville Medical Clinic is Po Box 247, Laurel, Mississippi and phone number is (601) 425-7550.

Ellisville Medical Clinic is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1801226287. 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) 477-8553.

Contact Information

Ellisville Medical Clinic
1203 Avenue B
Ellisville
MS 39437-2080
(601) 477-8553
(601) 477-9158

Map and Direction


Primary Care Clinic Profile

Full NameEllisville Medical Clinic
SpecialityFamily Medicine
Location1203 Avenue B, Ellisville, Mississippi
Authorized Official Name and PositionMonica Morrow (DIRECTOR CLINC SUPPORT)
Authorized Official Contact6014257550
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ellisville Medical Clinic
Po Box 247
Laurel
MS 39441-0247

Ph: (601) 425-7550		Ellisville Medical Clinic
1203 Avenue B
Ellisville
MS 39437-2080

Ph: (601) 477-8553

NPI Details:

NPI Number1801226287
Provider Enumeration Date11/20/2013
Last Update Date05/12/2015

Medicare PECOS Information:

Medicare PECOS PAC ID4385876655
Medicare Enrollment IDO20140515000834

Medical Identifiers

Medical identifiers for Ellisville Medical Clinic such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1801226287NPI-NPPES
03424516MedicaidMS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Ellisville Medical Clinic acts as a billing entity for following providers:
Provider NameRichard K Ivey
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1790703171
PECOS PAC ID: 0941107940
Enrollment ID: I20031218000545
Provider NamePhilip L Levin
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1619051877
PECOS PAC ID: 9638064405
Enrollment ID: I20040219000714
Provider NameMarvin R Dunbar
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1396794467
PECOS PAC ID: 6204727811
Enrollment ID: I20040323001044
Provider NameHerbert G Rogers
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1720092331
PECOS PAC ID: 6305738576
Enrollment ID: I20040325000372
Provider NameBenjamin Weber
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1669446001
PECOS PAC ID: 2365434222
Enrollment ID: I20040331001122
Provider NameHugh W Stancill
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1114966785
PECOS PAC ID: 5294727061
Enrollment ID: I20040401000175
Provider NameVincent C Dungan
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1134102296
PECOS PAC ID: 3678566114
Enrollment ID: I20040412000458
Provider NameJames K Fisher
Provider TypePractitioner - Anesthesiology
Provider IdentifiersNPI Number: 1639125768
PECOS PAC ID: 8628063187
Enrollment ID: I20040415000868
Provider NameRobert A Desantis
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1053350223
PECOS PAC ID: 9931097607
Enrollment ID: I20040616000654
Provider NameStephanie L Crosby
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1447299508
PECOS PAC ID: 4284618315
Enrollment ID: I20040616000773
Provider NameThomas E Dobbs
Provider TypePractitioner - Infectious Disease
Provider IdentifiersNPI Number: 1770597882
PECOS PAC ID: 6204811490
Enrollment ID: I20040622000663
Provider NameMark A Kelly
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1457394090
PECOS PAC ID: 3577549088
Enrollment ID: I20040625000634
Provider NameWassim E Mouannes
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1780799965
PECOS PAC ID: 9133199680
Enrollment ID: I20040730000531
Provider NameThomas Spiers
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1952313843
PECOS PAC ID: 8426020488
Enrollment ID: I20040810000842
Provider NameJames Huff
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1487694485
PECOS PAC ID: 3375517162
Enrollment ID: I20040826000209
Provider NameJohn Payne
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1760451991
PECOS PAC ID: 1052388782
Enrollment ID: I20040913001074
Provider NameKimberly G Dobbs
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1265456818
PECOS PAC ID: 0244208957
Enrollment ID: I20040921000521
Provider NameNorrapol Wattanasuwan
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1508801366
PECOS PAC ID: 6800784349
Enrollment ID: I20040921000947
Provider NameLyndell Sue Lee
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1013951854
PECOS PAC ID: 4688611775
Enrollment ID: I20050411000614
Provider NameJoseph A Proli
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1538277843
PECOS PAC ID: 8527002013
Enrollment ID: I20050615000691
Provider NameBilly C Chancellor
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1053328385
PECOS PAC ID: 2567406671
Enrollment ID: I20050620000029
Provider NameStephen P Johnson
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1750395356
PECOS PAC ID: 4587552252
Enrollment ID: I20050715000977
Provider NameRhonda Richardson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1457363780
PECOS PAC ID: 1456387893
Enrollment ID: I20050715001063
Provider NameSamuel W White
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1619916434
PECOS PAC ID: 7719905470
Enrollment ID: I20051110000783
Provider NameKenneth S Parker
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1407964844
PECOS PAC ID: 9931121480
Enrollment ID: I20051227000317
Provider NameJeffrey A Burns
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1033115597
PECOS PAC ID: 8325013246
Enrollment ID: I20060106000666
Provider NamePatricia Ann Miller
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1821032236
PECOS PAC ID: 5991729816
Enrollment ID: I20060118000960
Provider NameJohn F Hassell
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1235178997
PECOS PAC ID: 4284532383
Enrollment ID: I20060207000216
Provider NameTerry C Pitts
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1699714311
PECOS PAC ID: 9436164886
Enrollment ID: I20060207000545
Provider NameJack C Evans
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1396784187
PECOS PAC ID: 3678588993
Enrollment ID: I20060208000213
Provider NameJonathan S Jones
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1881617983
PECOS PAC ID: 2668478876
Enrollment ID: I20061011000526
Provider NameThomas B Baylis
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1467555771
PECOS PAC ID: 0941233035
Enrollment ID: I20061107000343
Provider NameCharles E Saul
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1003849068
PECOS PAC ID: 5395633069
Enrollment ID: I20070509000411
Provider NameSonya Everett
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1619916103
PECOS PAC ID: 2860584216
Enrollment ID: I20070815000583
Provider NameBassam K Mechleb
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1063625325
PECOS PAC ID: 7911090295
Enrollment ID: I20070831000283
Provider NameRobin H Schwartz
Provider TypePractitioner - Anesthesiology
Provider IdentifiersNPI Number: 1518990266
PECOS PAC ID: 4789774324
Enrollment ID: I20071219000426
Provider NameKaren S Temple
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1295776078
PECOS PAC ID: 5092897421
Enrollment ID: I20080124000315
Provider NameChad D Caraway
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1205052164
PECOS PAC ID: 9436232170
Enrollment ID: I20080219000084
Provider NameRandall W Graham
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1184647885
PECOS PAC ID: 4587742515
Enrollment ID: I20080416000364
Provider NameDavid L Harrison
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1497702302
PECOS PAC ID: 6002985892
Enrollment ID: I20080520000373
Provider NameStacey S Nix
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1154598357
PECOS PAC ID: 3173699154
Enrollment ID: I20080828000290
Provider NameJeremy C Mauldin
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1376792028
PECOS PAC ID: 1759442023
Enrollment ID: I20081204000645
Provider NameKim L Beard
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1609849553
PECOS PAC ID: 6709935406
Enrollment ID: I20090529000340
Provider NameDanielle Blakeney
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1942402029
PECOS PAC ID: 5294885992
Enrollment ID: I20090617000545
Provider NameAmber L Touchstone
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1194967794
PECOS PAC ID: 2860543956
Enrollment ID: I20090701000171
Provider NameJames M Beasley
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1689696817
PECOS PAC ID: 0547296972
Enrollment ID: I20091204000486
Provider NameCarolyn Cegielski
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1225052863
PECOS PAC ID: 3870481542
Enrollment ID: I20091204000499
Provider NameWilliam David Sullivan
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1659385276
PECOS PAC ID: 2860428299
Enrollment ID: I20091204000521
Provider NameCharles D Cannon
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1841214145
PECOS PAC ID: 9537195961
Enrollment ID: I20091217000571
Provider NameWillus Mark Horne
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1417961012
PECOS PAC ID: 5890721229
Enrollment ID: I20091217000605
Provider NameMark W Norton
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1881608495
PECOS PAC ID: 2163458597
Enrollment ID: I20091218000235
Provider NameJesse Ezzell
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1912911843
PECOS PAC ID: 2264468693
Enrollment ID: I20100504000875
Provider NameMartha J Johnson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1700827250
PECOS PAC ID: 4981732948
Enrollment ID: I20100512000462
Provider NameJens F Graversen
Provider TypePractitioner - Urology
Provider IdentifiersNPI Number: 1932233392
PECOS PAC ID: 9931130382
Enrollment ID: I20100611000464
Provider NameMelissa A James
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1356664825
PECOS PAC ID: 4688704992
Enrollment ID: I20100614000255
Provider NameKenneth M Craven
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1750325528
PECOS PAC ID: 9537299680
Enrollment ID: I20100616000255
Provider NameDonald T Scoggin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1316980097
PECOS PAC ID: 0042334542
Enrollment ID: I20100907000487
Provider NameWilliam A Morrison
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1700827243
PECOS PAC ID: 5597950527
Enrollment ID: I20101116000408
Provider NameJulian K Grafton
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1568496669
PECOS PAC ID: 1658567128
Enrollment ID: I20101123000419
Provider NameKenneth L Smith
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1740220839
PECOS PAC ID: 2769679828
Enrollment ID: I20101215000440
Provider NameKisha Lashay Knight
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1023319936
PECOS PAC ID: 1456549740
Enrollment ID: I20110103000006
Provider NameThomas H Blake
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1558330415
PECOS PAC ID: 9638202500
Enrollment ID: I20110214000594
Provider NameSteven D Nowicki
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1306815907
PECOS PAC ID: 9436047107
Enrollment ID: I20110214000614
Provider NameJessica A Garner
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982913729
PECOS PAC ID: 2466635438
Enrollment ID: I20110329000471
Provider NameJudith L Bradley
Provider TypePractitioner - Ophthalmology
Provider IdentifiersNPI Number: 1457466690
PECOS PAC ID: 6800784570
Enrollment ID: I20110329000741
Provider NameHossein Nasajpour
Provider TypePractitioner - Plastic And Reconstructive Surgery
Provider IdentifiersNPI Number: 1003006602
PECOS PAC ID: 8325134752
Enrollment ID: I20110720000797
Provider NameKizzy Eymard Bailey
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1700046414
PECOS PAC ID: 6204976772
Enrollment ID: I20110809000014
Provider NameThomas Bailey
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1417118548
PECOS PAC ID: 5193851756
Enrollment ID: I20110809000086
Provider NameAmy Delane Adams
Provider TypePractitioner - Dermatology
Provider IdentifiersNPI Number: 1396993663
PECOS PAC ID: 3072782879
Enrollment ID: I20110812000179
Provider NameDebbie S Flowers
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1215222179
PECOS PAC ID: 0143490441
Enrollment ID: I20110824000222
Provider NameRichard M Okeeffe
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1366409005
PECOS PAC ID: 3870595457
Enrollment ID: I20110824000396
Provider NameTonia Holley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164727269
PECOS PAC ID: 7911179155
Enrollment ID: I20111011000642
Provider NameNick A Deniakos
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1427098565
PECOS PAC ID: 8022281757
Enrollment ID: I20111025000616
Provider NameJennifer Rebecca Roberts
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1528223005
PECOS PAC ID: 2860665502
Enrollment ID: I20111025000744
Provider NamePeyton Skinner
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1841575933
PECOS PAC ID: 8426223363
Enrollment ID: I20111205000774
Provider NameSheila D Bradford
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1700954765
PECOS PAC ID: 7315112802
Enrollment ID: I20111212000767
Provider NameDelane Pressly
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1609148212
PECOS PAC ID: 2062670284
Enrollment ID: I20120220000712
Provider NameGloria Alridge
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1386926434
PECOS PAC ID: 3971762568
Enrollment ID: I20120319000298
Provider NameDaniel M Mccallum
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1689758120
PECOS PAC ID: 5799670196
Enrollment ID: I20120807000821
Provider NameApril E Hunt
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1467716548
PECOS PAC ID: 9436309382
Enrollment ID: I20121030000462
Provider NameRonald P. Tynes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1033450333
PECOS PAC ID: 9032355896
Enrollment ID: I20130424000008
Provider NameHamit Kumar
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1174842330
PECOS PAC ID: 1850528688
Enrollment ID: I20131226000177
Provider NameWoo S Kim
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1427357847
PECOS PAC ID: 4880823871
Enrollment ID: I20140218000201
Provider NameMicah R Welborn
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1407289283
PECOS PAC ID: 0345470241
Enrollment ID: I20140219002002
Provider NameStephen Michael Bolivar
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1598199291
PECOS PAC ID: 7315178183
Enrollment ID: I20140319001072
Provider NameTeresa R Camp-rogers
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1265630842
PECOS PAC ID: 0345389474
Enrollment ID: I20140714001766
Provider NameCharles H Black
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1790988087
PECOS PAC ID: 0042497554
Enrollment ID: I20140725001863
Provider NameJeremy S Rogers
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1588955348
PECOS PAC ID: 5193941904
Enrollment ID: I20140730001981
Provider NameGeorge L Tarbutton
Provider TypePractitioner - Preventive Medicine
Provider IdentifiersNPI Number: 1538219399
PECOS PAC ID: 3971657727
Enrollment ID: I20140827000129
Provider NameDerrick L Burgess
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1720244932
PECOS PAC ID: 9335396449
Enrollment ID: I20140918001971
Provider NameJanna T. Phillips
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1477833770
PECOS PAC ID: 7517114499
Enrollment ID: I20140919002238
Provider NamePaul W Pickard
Provider TypePractitioner - Anesthesiology
Provider IdentifiersNPI Number: 1487679841
PECOS PAC ID: 1557427408
Enrollment ID: I20141208001632
Provider NameRhonda G. Smith
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1457754426
PECOS PAC ID: 7618290578
Enrollment ID: I20141229001049
Provider NameLacey Blakeney
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1326457151
PECOS PAC ID: 7214254010
Enrollment ID: I20150316000467
Provider NameJuebin Huang
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1477851996
PECOS PAC ID: 0840515144
Enrollment ID: I20150325000641
Provider NameKelly N Tullos
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1508125576
PECOS PAC ID: 0840421871
Enrollment ID: I20150625000644
Provider NameJeffrey D Miller
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1215310388
PECOS PAC ID: 6103134622
Enrollment ID: I20151002001886
Provider NameAshlynn Bennett
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1619345402
PECOS PAC ID: 8123338977
Enrollment ID: I20151105002319
Provider NameVicki Hampton
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1740226018
PECOS PAC ID: 9739480047
Enrollment ID: I20151210000941
Provider NameBrandi Tynes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1639547425
PECOS PAC ID: 2264736321
Enrollment ID: I20160210000736
Provider NameDiane D Speedling
Provider TypePractitioner - Anesthesiology
Provider IdentifiersNPI Number: 1104868397
PECOS PAC ID: 2365344777
Enrollment ID: I20160324000692
Provider NameLeslie Marie Jeffcoat
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1679932388
PECOS PAC ID: 9830497486
Enrollment ID: I20160414000887
Provider NameDeepu Raphael Thoppil
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1154580249
PECOS PAC ID: 4587832050
Enrollment ID: I20160510002136
Provider NameDiego Fernandez Garcia Roves
Provider TypePractitioner - Anesthesiology
Provider IdentifiersNPI Number: 1851656656
PECOS PAC ID: 5496045122
Enrollment ID: I20160608000747
Provider NameNikhil Mukhi
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1083920425
PECOS PAC ID: 2264726058
Enrollment ID: I20160802000593
Provider NameJoel T Shores
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1447690854
PECOS PAC ID: 4880914688
Enrollment ID: I20160802002867
Provider NameLaken B Miller
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1053763813
PECOS PAC ID: 0749574457
Enrollment ID: I20160803001152
Provider NameGulshan Oberoi
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1174801765
PECOS PAC ID: 4183910086
Enrollment ID: I20160831002942
Provider NameKelli P Mooney
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1205288495
PECOS PAC ID: 0941596852
Enrollment ID: I20160901000386
Provider NameElizabeth Danielle Welch
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1588119176
PECOS PAC ID: 6305132176
Enrollment ID: I20160902000184
Provider NameShreyas Gangadhara
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1992092548
PECOS PAC ID: 1658650510
Enrollment ID: I20161116002137
Provider NameMarkus Dick Craig
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1831597202
PECOS PAC ID: 3173847589
Enrollment ID: I20161129001607
Provider NameJohn W O'quinn
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1790229508
PECOS PAC ID: 0941581011
Enrollment ID: I20170103001846
Provider NamePilar L Kirkland
Provider TypePractitioner - Anesthesiology
Provider IdentifiersNPI Number: 1548233398
PECOS PAC ID: 6305906892
Enrollment ID: I20170719002165
Provider NameMegan R Tucker
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1356870141
PECOS PAC ID: 0547530784
Enrollment ID: I20170721000693
Provider NameAmandeep Singh
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1497197859
PECOS PAC ID: 7719294636
Enrollment ID: I20170816003714
Provider NameMichelle S V Napper
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1720439029
PECOS PAC ID: 6103114459
Enrollment ID: I20171020000700
Provider NameSachin V Patil
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1821355363
PECOS PAC ID: 5799051256
Enrollment ID: I20171027001355
Provider NameAshley S Floyd
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1609321702
PECOS PAC ID: 1355629635
Enrollment ID: I20171206001366
Provider NameCarrie A Foxworth
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1972018992
PECOS PAC ID: 8527328061
Enrollment ID: I20180201001943
Provider NameShawn Austin Taylor
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1821502634
PECOS PAC ID: 7214297332
Enrollment ID: I20180212000835
Provider NameJames Boyd Bronson
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1205274230
PECOS PAC ID: 5991067126
Enrollment ID: I20180327002271
Provider NameShashank Shekhar
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1356781629
PECOS PAC ID: 9032434873
Enrollment ID: I20180613003325
Provider NameErica C Windham
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982195137
PECOS PAC ID: 1456607530
Enrollment ID: I20180703000099
Provider NameSarah D Queck
Provider TypePractitioner - Ophthalmology
Provider IdentifiersNPI Number: 1194144386
PECOS PAC ID: 6406103621
Enrollment ID: I20180719000894
Provider NameAnna Lisa Seals
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801372685
PECOS PAC ID: 4385992916
Enrollment ID: I20180730002204
Provider NameEdmund G Chinchar
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1184035024
PECOS PAC ID: 5890069496
Enrollment ID: I20180803001917
Provider NameTerri Byrd
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1285135228
PECOS PAC ID: 4284983875
Enrollment ID: I20180815000482
Provider NameJames Keith Winstead
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1467865006
PECOS PAC ID: 1355634551
Enrollment ID: I20180827000581
Provider NameRegan M Roney
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730675612
PECOS PAC ID: 4183974108
Enrollment ID: I20180912000668
Provider NameDerrick D Trump
Provider TypePractitioner - Osteopathic Manipulative Medicine
Provider IdentifiersNPI Number: 1396108007
PECOS PAC ID: 1052661006
Enrollment ID: I20180926001652
Provider NameRebecca Suzanne Scarbrough
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1518443134
PECOS PAC ID: 9234480435
Enrollment ID: I20180927001702
Provider NameRachel W Cudworth
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1194143974
PECOS PAC ID: 5597980268
Enrollment ID: I20181001001479
Provider NameHeather Elizabeth Waters
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1700197977
PECOS PAC ID: 8426295296
Enrollment ID: I20181003002863
Provider NameCharles Steven Wood
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1356834766
PECOS PAC ID: 1557605714
Enrollment ID: I20181129001789
Provider NameMatthew James Kollar
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1316365547
PECOS PAC ID: 4385900349
Enrollment ID: I20190109000104
Provider NameRebekah C Kollar
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1356769640
PECOS PAC ID: 2668745993
Enrollment ID: I20190109000899
Provider NameRyan Matthew Miles
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1649749698
PECOS PAC ID: 4082952627
Enrollment ID: I20190206002925
Provider NameRachel Johnson
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1972031227
PECOS PAC ID: 2769721638
Enrollment ID: I20190312000713
Provider NameHanna Rae Mccoy
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730742933
PECOS PAC ID: 5496088544
Enrollment ID: I20190605001621
Provider NameMary G Morgan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1235698846
PECOS PAC ID: 4981938719
Enrollment ID: I20190627000652
Provider NameJenisus Marie Owens
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1316390289
PECOS PAC ID: 4688900475
Enrollment ID: I20190801000029
Provider NameSarah M Wooten
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1881253557
PECOS PAC ID: 7618204744
Enrollment ID: I20190812001939
Provider NameHeather Pritchett Bassi
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1447802103
PECOS PAC ID: 9537496427
Enrollment ID: I20190815001643
Provider NameOscar Kwaku Okyere
Provider TypePractitioner - Hospitalist
Provider IdentifiersNPI Number: 1164873071
PECOS PAC ID: 8921338229
Enrollment ID: I20190930002994
Provider NameRobert C Rivers
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1225163769
PECOS PAC ID: 1254663735
Enrollment ID: I20191102000236
Provider NameKacey Jones
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1992368799
PECOS PAC ID: 1052643558
Enrollment ID: I20191104000347
Provider NameElizabeth R Allen
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1659918084
PECOS PAC ID: 1052746435
Enrollment ID: I20200113000850
Provider NameAshley S Brooks
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164062295
PECOS PAC ID: 4587090717
Enrollment ID: I20200207000545
Provider NameJill L Nicholas
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1295288033
PECOS PAC ID: 3678994449
Enrollment ID: I20200603000530
Provider NameMichael J Gast
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1336671213
PECOS PAC ID: 5496027468
Enrollment ID: I20200805002660
Provider NameSeth B Ladd
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1427448786
PECOS PAC ID: 2961829585
Enrollment ID: I20200827003109
Provider NameMichael Sand
Provider TypePractitioner - Sleep Medicine
Provider IdentifiersNPI Number: 1932552148
PECOS PAC ID: 6103110820
Enrollment ID: I20200904000319
Provider NameHolly M White
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730799578
PECOS PAC ID: 7911325477
Enrollment ID: I20200915002023
Provider NameSamantha C Givens
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1497356562
PECOS PAC ID: 8820401888
Enrollment ID: I20210112000722
Provider NameKimberly Kennedy
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1093180531
PECOS PAC ID: 6204240377
Enrollment ID: I20210201001635
Provider NameBrittany Carney Gardner
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1720552268
PECOS PAC ID: 0446664254
Enrollment ID: I20210205000454
Provider NameCynthia Lynn Bean
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1003405754
PECOS PAC ID: 4587079975
Enrollment ID: I20210217001147
Provider NameRayhan A Tariq
Provider TypePractitioner - Pain Management
Provider IdentifiersNPI Number: 1508216680
PECOS PAC ID: 7911236211
Enrollment ID: I20210723003313
Provider NameBridget Burnham
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306411566
PECOS PAC ID: 3577967140
Enrollment ID: I20210803004019
Provider NameMichael A Sims
Provider TypePractitioner - Hospitalist
Provider IdentifiersNPI Number: 1962990259
PECOS PAC ID: 2961752290
Enrollment ID: I20210817002514
Provider NameKyle Bellamy
Provider TypePractitioner - Anesthesiology
Provider IdentifiersNPI Number: 1891226551
PECOS PAC ID: 4486928520
Enrollment ID: I20210820000427
Provider NameJeremy Todd Unger
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1881198075
PECOS PAC ID: 2163772484
Enrollment ID: I20210920000924
Provider NameLindsay Luke
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1912676313
PECOS PAC ID: 2264839794
Enrollment ID: I20210924002082
Provider NameSukriye Damla Kara
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1174054654
PECOS PAC ID: 1951708270
Enrollment ID: I20210928003829
Provider NameIllisia Marie Hodge
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1003486556
PECOS PAC ID: 2062800691
Enrollment ID: I20211101000338
Provider NamePilar Lyas
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1346990520
PECOS PAC ID: 8022496462
Enrollment ID: I20220526000043
Provider NameAlla Yugay
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1649624834
PECOS PAC ID: 1557745320
Enrollment ID: I20220827000122
Provider NameLaveena Singla
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1457702615
PECOS PAC ID: 8527322296
Enrollment ID: I20220901001317
Provider NameKunal Bhatia
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1790136851
PECOS PAC ID: 4082907787
Enrollment ID: I20220901003445
Provider NameAlison Redding
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1205398245
PECOS PAC ID: 2163758012
Enrollment ID: I20220905000423
Provider NameMonika Md Thoppil
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1043770845
PECOS PAC ID: 0547592347
Enrollment ID: I20220908003647
Provider NameSamuel Lindsey Hill
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1679295182
PECOS PAC ID: 2567848039
Enrollment ID: I20221006001661
Provider NameJonathan Redding
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1740742683
PECOS PAC ID: 4587990445
Enrollment ID: I20221018001960
Provider NameBailee Cerra
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1225752488
PECOS PAC ID: 3476918772
Enrollment ID: I20230420000127
Provider NameAlexis J Alvarado Arias
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1205290525
PECOS PAC ID: 5890088090
Enrollment ID: I20230626002478
Provider NameLarry Ethan Milton
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1699394098
PECOS PAC ID: 6507227766
Enrollment ID: I20230803003006
Provider NameMichael Mccain
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1588293385
PECOS PAC ID: 2567881899
Enrollment ID: I20230809001896
Provider NameBernard Vinoski
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1366405540
PECOS PAC ID: 5496811705
Enrollment ID: I20230825000763
Provider NameAmit Ahuja
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1528061959
PECOS PAC ID: 1153301668
Enrollment ID: I20230828002537
Provider NameNikhil Suresh Shah
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1104810027
PECOS PAC ID: 4688574304
Enrollment ID: I20231025000031
Provider NameAngela Jones
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1245360916
PECOS PAC ID: 1759738727
Enrollment ID: I20240129004568
Provider NameRoderick Cutrer
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1386176162
PECOS PAC ID: 5395192231
Enrollment ID: I20240130003593

Reviews and Comments


Family Medicine in Ellisville, MS

Family Health Center Inc
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 5192 Highway 11 N, Ellisville, MS 39437
Phone: 601-425-3033    Fax: 601-428-6561
Jfmc Ellisville, Llc
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 602 Hill St, Ellisville, MS 39437
Phone: 601-719-0092    Fax: 601-719-0473
Ellisville Pediatric Clinic
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 1203 Ave B, Suite 200, Ellisville, MS 39437
Phone: 601-477-3550    Fax: 601-477-2236
Hattiesburg Clinic Pa
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 822 Main St, Ellisville, MS 39437
Phone: 601-477-2014    Fax: 601-477-9942
Ellisville State School
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 1101 Hwy 11 S, Ellisville, MS 39437
Phone: 601-477-9384    Fax: 601-477-5700
Fast Pace Mississippi, Pllc
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 305 Hill St, Ellisville, MS 39437
Phone: 601-800-0118    

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.