| Cch Clinic Seminary | |
|
104 W Main St Seminary MS 39479-9027 | |
| (601) 722-3610 | |
| (601) 722-9985 |
| Full Name | Cch Clinic Seminary |
|---|---|
| Speciality | Clinic/Center |
| Location | 104 W Main St, Seminary, Mississippi |
| Authorized Official Name and Position | Anissa L Evans (CREDENTIALS) |
| Authorized Official Contact | 6016980328 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cch Clinic Seminary Po Box 2499 Collins MS 39428-2499 Ph: (601) 722-3610 | Cch Clinic Seminary 104 W Main St Seminary MS 39479-9027 Ph: (601) 722-3610 |
| NPI Number | 1134435498 |
|---|---|
| Provider Enumeration Date | 08/25/2010 |
| Last Update Date | 08/06/2024 |
| Medicare PECOS PAC ID | 4183517253 |
|---|---|
| Medicare Enrollment ID | O20110413000929 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134435498 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | James H Shivers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942471115 PECOS PAC ID: 6406920727 Enrollment ID: I20080805000574 |
| Provider Name | Ginger N Pace-herndon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649480971 PECOS PAC ID: 1951460062 Enrollment ID: I20081104000718 |
| Provider Name | Jennifer R Leggett-hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801100037 PECOS PAC ID: 3476748427 Enrollment ID: I20101116000588 |
| Provider Name | Karen R Pitts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467729293 PECOS PAC ID: 7113193251 Enrollment ID: I20111220000631 |
| Provider Name | Terri Bickham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457668162 PECOS PAC ID: 7911131768 Enrollment ID: I20131009001742 |
| Provider Name | Nicole Lott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861809402 PECOS PAC ID: 8628297959 Enrollment ID: I20140917002925 |
| Provider Name | Lacey Blakeney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326457151 PECOS PAC ID: 7214254010 Enrollment ID: I20150316000467 |
| Provider Name | Melissa Coulson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235581513 PECOS PAC ID: 8729371737 Enrollment ID: I20160728002112 |
| Provider Name | Christie L Kellar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184161457 PECOS PAC ID: 6901183094 Enrollment ID: I20170427000044 |
| Provider Name | Crystal P Mcnabb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326565763 PECOS PAC ID: 5193086403 Enrollment ID: I20180301001879 |
| Provider Name | Twylia M. Aultman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912483405 PECOS PAC ID: 3072863000 Enrollment ID: I20180912001218 |
| Provider Name | Felicia S Stewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477011161 PECOS PAC ID: 9830431444 Enrollment ID: I20190501001619 |
| Provider Name | Bria Goff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457904989 PECOS PAC ID: 4688906183 Enrollment ID: I20191104000414 |
| Provider Name | Ariale Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790319945 PECOS PAC ID: 8527481845 Enrollment ID: I20200706000808 |
| Provider Name | Destiny D Epting |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710598230 PECOS PAC ID: 5193141539 Enrollment ID: I20200817002458 |
| Provider Name | Shelby Fnp Dickerson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457116907 PECOS PAC ID: 2668813841 Enrollment ID: I20240520000588 |
The Family Clinic Of Seminary Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 215 Bobby Beasley St, Seminary, MS 39479 Phone: 601-722-4300 Fax: 601-722-9092 | |
Seminary High School Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Main Street, Seminary, MS 39479 Phone: 601-545-8700 Fax: 601-450-2493 | |
Seminary Elementary School Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Main St, Seminary, MS 39479 Phone: 601-545-8700 Fax: 601-450-2493 | |
Seminary Family Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 100 Highway 535, Seminary, MS 39479 Phone: 601-722-3208 Fax: 601-722-3304 | |
Seminary Middle School Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Main Street, Seminary, MS 39479 Phone: 601-545-8700 Fax: 601-450-2493 |