| Mid-south Convenient Care, Pllc | |
|
521 Hwy 51 North Ripley TN 38063 | |
| (731) 286-6611 | |
| Not Available |
| Full Name | Mid-south Convenient Care, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 521 Hwy 51 North, Ripley, Tennessee |
| Authorized Official Name and Position | Pankaj Srivastava (OWNER) |
| Authorized Official Contact | 7314454987 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid-south Convenient Care, Pllc 1445 Us Highway 51 Byp E Suite B Dyersburg TN 38024-2127 Ph: (731) 286-1900 | Mid-south Convenient Care, Pllc 521 Hwy 51 North Ripley TN 38063 Ph: (731) 286-6611 |
| NPI Number | 1477984508 |
|---|---|
| Provider Enumeration Date | 11/27/2013 |
| Last Update Date | 08/02/2017 |
| Medicare PECOS PAC ID | 0749412377 |
|---|---|
| Medicare Enrollment ID | O20140415000632 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477984508 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD0000034709 (Tennessee) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Pankaj Srivastava |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487655957 PECOS PAC ID: 6204826142 Enrollment ID: I20040513001027 |
| Provider Name | Connie A Reaves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255476677 PECOS PAC ID: 8628052131 Enrollment ID: I20040614001046 |
| Provider Name | Syble S Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891797924 PECOS PAC ID: 2860454782 Enrollment ID: I20041102001032 |
| Provider Name | Jan A Sims |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205832920 PECOS PAC ID: 4880600584 Enrollment ID: I20060306000207 |
| Provider Name | Keata Anthony |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952351355 PECOS PAC ID: 4981708609 Enrollment ID: I20070404000551 |
| Provider Name | Angeli Jain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467594184 PECOS PAC ID: 4880747914 Enrollment ID: I20090806000361 |
| Provider Name | Elesa A Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821328121 PECOS PAC ID: 2567591050 Enrollment ID: I20100521000005 |
| Provider Name | Leigh A Lehmann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457499824 PECOS PAC ID: 7214112945 Enrollment ID: I20110425000024 |
| Provider Name | Sandra Dennis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174768485 PECOS PAC ID: 3476713066 Enrollment ID: I20120319000475 |
| Provider Name | James Tetleton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891035044 PECOS PAC ID: 5092952333 Enrollment ID: I20130506000363 |
| Provider Name | Jena Burlison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851634166 PECOS PAC ID: 4688813645 Enrollment ID: I20130624000311 |
| Provider Name | John Beasley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568837144 PECOS PAC ID: 1052615564 Enrollment ID: I20160203001957 |
| Provider Name | Ashley C Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316465826 PECOS PAC ID: 2668735994 Enrollment ID: I20180418002347 |
| Provider Name | Ayishia K Lowe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669818043 PECOS PAC ID: 4385874296 Enrollment ID: I20180510000021 |
| Provider Name | Brittany Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538690342 PECOS PAC ID: 7416212014 Enrollment ID: I20180601000509 |
| Provider Name | Preeti Srivastava |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043806516 PECOS PAC ID: 2062829807 Enrollment ID: I20210324000290 |
| Provider Name | Katrina J Korszoloski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417479965 PECOS PAC ID: 3173889094 Enrollment ID: I20210422003165 |
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