Green Tree Family Medical Clinic - Medicare Primary Care in Mt. Olive, MS

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Green Tree Family Medical Clinic is a medicare enrolled primary clinic (Clinic/center - Rural Health) in Mt. Olive, Mississippi. The current practice location for Green Tree Family Medical Clinic is 603 South Main Street, Mt. Olive, Mississippi. For appointments, you can reach them via phone at (601) 797-3405. The mailing address for Green Tree Family Medical Clinic is Po Box 1107, Mount Olive, Mississippi and phone number is (601) 797-3405.

Green Tree Family Medical Clinic is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1336447861. 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) 797-3405.

Contact Information

Green Tree Family Medical Clinic
603 South Main Street
Mt. Olive
MS 39119-4945
(601) 797-3405
Not Available

Map and Direction


Primary Care Clinic Profile

Full NameGreen Tree Family Medical Clinic
SpecialityClinic/Center
Location603 South Main Street, Mt. Olive, Mississippi
Authorized Official Name and PositionKirstie Evans (CFO)
Authorized Official Contact6017656711
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Green Tree Family Medical Clinic
Po Box 1107
Mount Olive
MS 39119-4945

Ph: (601) 797-3405		Green Tree Family Medical Clinic
603 South Main Street
Mt. Olive
MS 39119-4945

Ph: (601) 797-3405

NPI Details:

NPI Number1336447861
Provider Enumeration Date03/08/2011
Last Update Date10/05/2011

Medicare PECOS Information:

Medicare PECOS PAC ID4183517253
Medicare Enrollment IDO20110519000619

Medical Identifiers

Medical identifiers for Green Tree Family Medical Clinic such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1336447861NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QR1300XClinic/center - Rural Health (* (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. Green Tree Family Medical Clinic acts as a billing entity for following providers:
Provider NameJeffrey J Mitchell
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1942234232
PECOS PAC ID: 1557311032
Enrollment ID: I20050124000631
Provider NameMary S Watkins
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245323914
PECOS PAC ID: 3072610229
Enrollment ID: I20070522000691
Provider NameWord Johnston
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1952305567
PECOS PAC ID: 3173540358
Enrollment ID: I20100803000398
Provider NameJennifer R Leggett-hudson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801100037
PECOS PAC ID: 3476748427
Enrollment ID: I20101116000588
Provider NameKaren R Pitts
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1467729293
PECOS PAC ID: 7113193251
Enrollment ID: I20111220000631
Provider NameBrian K Padgett
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1750677704
PECOS PAC ID: 3173787702
Enrollment ID: I20120612000442
Provider NameNicole Lott
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1861809402
PECOS PAC ID: 8628297959
Enrollment ID: I20140917002925
Provider NameLacey Blakeney
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1326457151
PECOS PAC ID: 7214254010
Enrollment ID: I20150316000467
Provider NameKatie Rush
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1891183208
PECOS PAC ID: 6204156821
Enrollment ID: I20150528000034
Provider NameMelissa Coulson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1235581513
PECOS PAC ID: 8729371737
Enrollment ID: I20160728002112
Provider NameChristie L Kellar
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1184161457
PECOS PAC ID: 6901183094
Enrollment ID: I20170427000044
Provider NameNatalie R Keyes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1285144584
PECOS PAC ID: 6608137971
Enrollment ID: I20180301000326
Provider NameCrystal P Mcnabb
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1326565763
PECOS PAC ID: 5193086403
Enrollment ID: I20180301001879
Provider NameAnna Lisa Seals
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801372685
PECOS PAC ID: 4385992916
Enrollment ID: I20180730002204
Provider NameTwylia M. Aultman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1912483405
PECOS PAC ID: 3072863000
Enrollment ID: I20180912001218
Provider NameFelicia S Stewart
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1477011161
PECOS PAC ID: 9830431444
Enrollment ID: I20190501001619
Provider NameBria Goff
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1457904989
PECOS PAC ID: 4688906183
Enrollment ID: I20191104000414
Provider NameAriale Nelson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1790319945
PECOS PAC ID: 8527481845
Enrollment ID: I20200706000808
Provider NameDestiny D Epting
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1710598230
PECOS PAC ID: 5193141539
Enrollment ID: I20200817002458
Provider NameAmanda Cooley
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1841723251
PECOS PAC ID: 6406120369
Enrollment ID: I20210625002693
Provider NameWeaton M Middleton
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1467022939
PECOS PAC ID: 3678970571
Enrollment ID: I20210920002548

Reviews and Comments


Clinic/Center in Mt. Olive, MS

Green Tree Family Medical Clinic
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 603 Main Street, Mt. Olive, MS 39119
Phone: 601-797-3405    Fax: 601-797-4707

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.