| Sumrall Family Health Center | |
|
1016 Highway 42 Sumrall MS 39482-9634 | |
| (601) 758-4214 | |
| (601) 758-0614 |
| Full Name | Sumrall Family Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1016 Highway 42, Sumrall, Mississippi |
| Authorized Official Name and Position | Geroldean Dyse (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6015458700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sumrall Family Health Center Po Box 1729 Hattiesburg MS 39403-1729 Ph: (601) 545-3700 | Sumrall Family Health Center 1016 Highway 42 Sumrall MS 39482-9634 Ph: (601) 758-4214 |
| NPI Number | 1184694036 |
|---|---|
| Provider Enumeration Date | 01/24/2006 |
| Last Update Date | 04/15/2021 |
| Medicare PECOS PAC ID | 2466342605 |
|---|---|
| Medicare Enrollment ID | O20040319000300 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184694036 | NPI | - | NPPES |
| 09013879 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Benjamin Weber |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669446001 PECOS PAC ID: 2365434222 Enrollment ID: I20040331001122 |
| Provider Name | Keith A Kersten |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861445108 PECOS PAC ID: 7719960848 Enrollment ID: I20040610000501 |
| Provider Name | Brandon L Coleman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881685782 PECOS PAC ID: 5597743922 Enrollment ID: I20040712000543 |
| Provider Name | Lisa D Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487631461 PECOS PAC ID: 5991777195 Enrollment ID: I20040809000911 |
| Provider Name | Laura C Singley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023064276 PECOS PAC ID: 5597781146 Enrollment ID: I20051021000879 |
| Provider Name | Quenyatta Echols-williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255392841 PECOS PAC ID: 8628085495 Enrollment ID: I20060320000536 |
| Provider Name | Patricia A Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902926488 PECOS PAC ID: 7719079110 Enrollment ID: I20070919000474 |
| Provider Name | Ann A Williams |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1669524278 PECOS PAC ID: 2062317944 Enrollment ID: I20080211000001 |
| Provider Name | James W Griffin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720274327 PECOS PAC ID: 8224114327 Enrollment ID: I20080331000203 |
| Provider Name | Ronda C Eason-hinton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952570723 PECOS PAC ID: 0446329593 Enrollment ID: I20080515000640 |
| Provider Name | Susan E Gentry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952575193 PECOS PAC ID: 2961573639 Enrollment ID: I20080624000510 |
| 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 | Christy Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750399531 PECOS PAC ID: 8921141318 Enrollment ID: I20100208000294 |
| Provider Name | Catherine M Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093796500 PECOS PAC ID: 9335272335 Enrollment ID: I20100728000072 |
| Provider Name | Kisha Lashay Knight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023319936 PECOS PAC ID: 1456549740 Enrollment ID: I20110103000006 |
| Provider Name | Jennifer Rebecca Roberts |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1528223005 PECOS PAC ID: 2860665502 Enrollment ID: I20111025000744 |
| Provider Name | Tracy Leigh Ladner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003239294 PECOS PAC ID: 1951532225 Enrollment ID: I20140331000478 |
| Provider Name | Ruthie B Zinn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598001562 PECOS PAC ID: 9537391354 Enrollment ID: I20140410000191 |
| Provider Name | Joshua Peter Hand |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689664039 PECOS PAC ID: 8921046863 Enrollment ID: I20140501001567 |
| Provider Name | Stephanie P Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497150056 PECOS PAC ID: 9830412196 Enrollment ID: I20141218000795 |
| Provider Name | Karen Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386930477 PECOS PAC ID: 9931423431 Enrollment ID: I20150109000963 |
| Provider Name | Trish Brix Baskin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316206519 PECOS PAC ID: 9234442609 Enrollment ID: I20150715000485 |
| Provider Name | Robin Murphree |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164898474 PECOS PAC ID: 7113227539 Enrollment ID: I20151207002740 |
| Provider Name | Stephanie Rachelle Lumpkin-freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407301237 PECOS PAC ID: 9638466824 Enrollment ID: I20161003002465 |
| Provider Name | Aspen J Hardges |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649715004 PECOS PAC ID: 4880976638 Enrollment ID: I20170131001758 |
| Provider Name | Veronica Tassin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144626946 PECOS PAC ID: 7113201799 Enrollment ID: I20170906001592 |
| Provider Name | Rasheeda C Hall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114280591 PECOS PAC ID: 0345483004 Enrollment ID: I20171005001983 |
| Provider Name | Martia Moffett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386154243 PECOS PAC ID: 3476829466 Enrollment ID: I20171018002754 |
| Provider Name | Amanda Landrum-mccallum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366943425 PECOS PAC ID: 6800159443 Enrollment ID: I20180413001128 |
| Provider Name | Lauren O'neal Garner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881199818 PECOS PAC ID: 9638433501 Enrollment ID: I20180430001758 |
| Provider Name | Jennifer Miranda Summers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225514391 PECOS PAC ID: 2769730555 Enrollment ID: I20180810001266 |
| Provider Name | Charlene Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235599515 PECOS PAC ID: 3274828330 Enrollment ID: I20180829000792 |
| Provider Name | April Rose Hinton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780160523 PECOS PAC ID: 7517210990 Enrollment ID: I20181101001312 |
| Provider Name | Kimberly Michelle Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891260808 PECOS PAC ID: 8820342256 Enrollment ID: I20181121000158 |
| Provider Name | William Michael Bird |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316431166 PECOS PAC ID: 4082959432 Enrollment ID: I20181213001070 |
| Provider Name | Charles F Diamond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659844496 PECOS PAC ID: 8820337330 Enrollment ID: I20190228000115 |
| Provider Name | John Michael Woods |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821093691 PECOS PAC ID: 8123175171 Enrollment ID: I20190424001219 |
| Provider Name | Thompson Worth Liddell |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1851703201 PECOS PAC ID: 1456685833 Enrollment ID: I20190619002545 |
| Provider Name | Jason Moss |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1235558149 PECOS PAC ID: 2567735939 Enrollment ID: I20190809002220 |
| Provider Name | Samantha C Givens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497356562 PECOS PAC ID: 8820401888 Enrollment ID: I20210112000722 |
| Provider Name | Natalia A Stevenson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053486852 PECOS PAC ID: 2466601091 Enrollment ID: I20210716001832 |
| Provider Name | Mae Lynn Ramsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790379964 PECOS PAC ID: 1153724687 Enrollment ID: I20210721003614 |
| Provider Name | Michelle E Howard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013149384 PECOS PAC ID: 6800285404 Enrollment ID: I20211122000995 |
| Provider Name | Jennifer Goodwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083246474 PECOS PAC ID: 1355733924 Enrollment ID: I20220112001446 |
| Provider Name | Erica "courtney" Moss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548492945 PECOS PAC ID: 2860615473 Enrollment ID: I20220705000379 |
| Provider Name | Senate Oluwakemi Amusu |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1700309432 PECOS PAC ID: 8628494408 Enrollment ID: I20221108000504 |
| Provider Name | Aretha M. Northington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811511819 PECOS PAC ID: 5890167027 Enrollment ID: I20230215002613 |
| Provider Name | Johanna M Alvarez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588219083 PECOS PAC ID: 1153781463 Enrollment ID: I20230718004321 |
Sumrall Elementary School Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 198 Todd Rd, Sumrall, MS 39482 Phone: 601-758-4289 Fax: 601-796-9437 | |
Sumrall High School Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 184 Center Ave, Sumrall, MS 39482 Phone: 601-758-4730 Fax: 601-796-9437 | |
South Mississippi Emergency Physicians,pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4891 Highway 589, Sumrall, MS 39482 Phone: 601-758-4606 Fax: 601-758-4615 | |
Covington Health Sumrall Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1039 Highway 42 Ste C, Sumrall, MS 39482 Phone: 601-765-6711 Fax: 601-698-0112 | |
Hattiesburg Clinic Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1238 Highway 42, Sumrall, MS 39482 Phone: 601-758-3100 Fax: 601-758-3060 | |
Sumrall Middle School Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1217 Highway 42, Sumrall, MS 39482 Phone: 601-758-4416 Fax: 601-796-9437 |