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RIDGELAND MEDICAL CLINIC NPI 1053917849


NPI Information

NPI: 1053917849
Provider Name: RIDGELAND MEDICAL CLINIC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 25D2202829

Address:
587 HIGHWAY 51 STE T
RIDGELAND, MS
ZIP 39157
Phone: (601) 790-7711
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RIDGELAND MEDICAL CLINIC is a family medicine in Ridgeland, MS. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. RIDGELAND MEDICAL CLINIC NPI is 1053917849. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

587 HIGHWAY 51 STE T
RIDGELAND, MS
ZIP 39157-567
Phone: (601) 790-7711
Fax: (601) 790-7712

The provider's authorized official is Jody Adams .
The authorized official title is Nurse Practitioner and has the following contact phone number (601) 790-7711.

The CLIA number assigned to this NPI record is 25D2202829 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/8/2020 and was last updated on 12/8/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.