Ridgeland Medical Clinic | |
587 Highway 51 Ste T Ridgeland MS 39157-2567 | |
(601) 790-7711 | |
(601) 790-7712 |
Full Name | Ridgeland Medical Clinic |
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Speciality | Family Medicine |
Location | 587 Highway 51 Ste T, Ridgeland, Mississippi |
Authorized Official Name and Position | Jody Adams (NURSE PRACTITIONER) |
Authorized Official Contact | 6017907711 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ridgeland Medical Clinic 587 Highway 51 Ste T Ridgeland MS 39157-2567 Ph: (601) 790-7711 | Ridgeland Medical Clinic 587 Highway 51 Ste T Ridgeland MS 39157-2567 Ph: (601) 790-7711 |
NPI Number | 1053917849 |
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Provider Enumeration Date | 12/08/2020 |
Last Update Date | 12/08/2020 |
Medicare PECOS PAC ID | 9032524400 |
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Medicare Enrollment ID | O20210217000175 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053917849 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Barbara A Bradley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124064068 PECOS PAC ID: 1951203181 Enrollment ID: I20040127000212 |
Provider Name | Massie Headley |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1649249426 PECOS PAC ID: 0446145288 Enrollment ID: I20040219000497 |
Provider Name | Jody T Adams |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780652362 PECOS PAC ID: 1456246131 Enrollment ID: I20040220000479 |
Provider Name | Laurie B Robinson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053355024 PECOS PAC ID: 7911976352 Enrollment ID: I20041001000163 |
Provider Name | William D. Whitton |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1790754307 PECOS PAC ID: 8325027063 Enrollment ID: I20041110000268 |
Provider Name | Calvin Ramsey |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1508919648 PECOS PAC ID: 0143131037 Enrollment ID: I20111108000829 |
Provider Name | Amanda B Greene |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083040562 PECOS PAC ID: 0547277980 Enrollment ID: I20140617002012 |
Provider Name | Leah S Mcgehee |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265825962 PECOS PAC ID: 5193044931 Enrollment ID: I20150429001873 |
Provider Name | Sabrina B Matthews |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043662430 PECOS PAC ID: 7416953047 Enrollment ID: I20160913000669 |
Provider Name | Lonnie L Moore |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962852988 PECOS PAC ID: 8820386451 Enrollment ID: I20161013001187 |
Provider Name | Jason Brian Copeland |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326538315 PECOS PAC ID: 6901157874 Enrollment ID: I20180918000176 |
Provider Name | Mary Hannah Bucklew |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467024901 PECOS PAC ID: 0446657340 Enrollment ID: I20210920002337 |
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