Walnut Grove Clinic - Medicare Primary Care in Walnut Grove, MS

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Walnut Grove Clinic is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Walnut Grove, Mississippi. The current practice location for Walnut Grove Clinic is 199 Rimmer St, Walnut Grove, Mississippi. For appointments, you can reach them via phone at (601) 253-2733. The mailing address for Walnut Grove Clinic is Po Box 142, Sebastopol, Mississippi and phone number is (601) 625-7140.

Walnut Grove Clinic is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1255387619. 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) 253-2733.

Contact Information

Walnut Grove Clinic
199 Rimmer St
Walnut Grove
MS 39189
(601) 253-2733
(601) 253-2733

Map and Direction


Primary Care Clinic Profile

Full NameWalnut Grove Clinic
SpecialityClinic/Center
Location199 Rimmer St, Walnut Grove, Mississippi
Authorized Official Name and PositionJill Bishop (CEO)
Authorized Official Contact6016257140
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Walnut Grove Clinic
Po Box 142
Sebastopol
MS 39359

Ph: (601) 625-7140		Walnut Grove Clinic
199 Rimmer St
Walnut Grove
MS 39189

Ph: (601) 253-2733

NPI Details:

NPI Number1255387619
Provider Enumeration Date05/26/2006
Last Update Date11/15/2019

Medicare PECOS Information:

Medicare PECOS PAC ID0941103717
Medicare Enrollment IDO20040129000363

Medical Identifiers

Medical identifiers for Walnut Grove Clinic such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1255387619NPI-NPPES
DA1146OtherRAILROAD MEDICARE
09013670MedicaidMS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QF0400XClinic/center - Federally Qualified Health Center (fqhc) (* (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. Walnut Grove Clinic acts as a billing entity for following providers:
Provider NameJames W Lock
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1063499002
PECOS PAC ID: 3577542406
Enrollment ID: I20040715000296
Provider NameKayti Powell
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730340563
PECOS PAC ID: 2860560695
Enrollment ID: I20081007000582
Provider NameKeisha L Oliphant
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1679710933
PECOS PAC ID: 5698830222
Enrollment ID: I20090216000324
Provider NameKaren Reece
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1609853647
PECOS PAC ID: 0345370482
Enrollment ID: I20100616000128
Provider NameRhonda P Davis
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1043292931
PECOS PAC ID: 5698933471
Enrollment ID: I20120224000538
Provider NameClaudia Bowman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1174892822
PECOS PAC ID: 3476712712
Enrollment ID: I20120306000964
Provider NameAmber S Riley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1841538030
PECOS PAC ID: 5890921035
Enrollment ID: I20131119000374
Provider NameWendy D Gressett
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1689096505
PECOS PAC ID: 6103049259
Enrollment ID: I20140519001718
Provider NameTelitha K Grant-spencer
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1851570006
PECOS PAC ID: 1658447891
Enrollment ID: I20161111000595
Provider NameBenita J Myles
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1790129021
PECOS PAC ID: 8123324522
Enrollment ID: I20161216002202
Provider NameGaydon Nowell
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1205355781
PECOS PAC ID: 2961778220
Enrollment ID: I20171101001228
Provider NameRagen Layne Smith
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1710472758
PECOS PAC ID: 1557619988
Enrollment ID: I20180801002495
Provider NameMary R Thomas
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1881241123
PECOS PAC ID: 3678804309
Enrollment ID: I20191011000011
Provider NameAshley Kaye Barber
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396394599
PECOS PAC ID: 0446675912
Enrollment ID: I20200730002010
Provider NameGloria A Graham
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1932519964
PECOS PAC ID: 0244506764
Enrollment ID: I20201102001873
Provider NameAmanda Cooley
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1841723251
PECOS PAC ID: 6406120369
Enrollment ID: I20210625002693
Provider NameAnna K Woods
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1912686296
PECOS PAC ID: 7214390053
Enrollment ID: I20230828002027
Provider NameKathy Gray
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1952548646
PECOS PAC ID: 9830547066
Enrollment ID: I20240517000730

Reviews and Comments


Clinic/Center in Walnut Grove, MS

Walnut Grove Medical Associates
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 110 Park St, Walnut Grove, MS 39189
Phone: 601-253-0173    Fax: 601-253-0176
Bmc Leake Walnut Grove Primary Care
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 110 Park St, Walnut Grove, MS 39189
Phone: 601-267-1400    

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.