Making Moves In The Community, Incorporated | |
112 East Peeler Ave Shaw MS 38773 | |
(662) 402-1138 | |
Not Available |
Full Name | Making Moves In The Community, Incorporated |
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Speciality | Family Medicine |
Location | 112 East Peeler Ave, Shaw, Mississippi |
Authorized Official Name and Position | Nora Gough-davis (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 6627543301 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Making Moves In The Community, Incorporated Po Box 299 Shaw MS 38773-0299 Ph: () - | Making Moves In The Community, Incorporated 112 East Peeler Ave Shaw MS 38773 Ph: (662) 402-1138 |
NPI Number | 1851884266 |
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Provider Enumeration Date | 06/11/2018 |
Last Update Date | 01/12/2021 |
Medicare PECOS PAC ID | 4284038738 |
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Medicare Enrollment ID | O20210806000017 |
Identifier | Type | State | Issuer |
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1851884266 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Nora C Gough-davis |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740410661 PECOS PAC ID: 0749322345 Enrollment ID: I20100120000411 |
Provider Name | Williemary Bolden |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518428283 PECOS PAC ID: 4587994181 Enrollment ID: I20190925000170 |
Provider Name | Vanessa Haywood |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700417961 PECOS PAC ID: 0547681264 Enrollment ID: I20200605000675 |
Provider Name | Sharron S Moore |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568002145 PECOS PAC ID: 1759700677 Enrollment ID: I20200925002537 |
Provider Name | Regina J Evans |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609416544 PECOS PAC ID: 5991124562 Enrollment ID: I20200930003267 |
Provider Name | Tomeka R Wright Little |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609499904 PECOS PAC ID: 7315367968 Enrollment ID: I20201020001735 |
Making Moves In The Community, Incorporated Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 601 Highway 61, Shaw, MS 38773 Phone: 662-545-7014 | |
Shaw Community Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 Peeler Ave, Shaw, MS 38773 Phone: 662-754-2060 | |
Shaw Community Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 Peeler Ave, Shaw, MS 38773 Phone: 662-332-8848 | |
Maximum Care After Hours Clinic, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 212 Highway 61, Shaw, MS 38773 Phone: 662-588-8009 | |
Shaw Family Medical Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 112 W Peeler Ave, Shaw, MS 38773 Phone: 662-754-3301 Fax: 662-754-3304 |