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WOODLAND CLINIC LLC NPI 1629282330


NPI Information

NPI: 1629282330
Provider Name: WOODLAND CLINIC LLC

Former Legal Business Name: WOODLAND CLINIC LLC

Classification: Family Medicine - 207QH0002X
Entity Type: Organization

Specialization: Hospice and Palliative Medicine

Address:
120 MARKET ST
WOODLAND, MS
ZIP 39776
Phone: (662) 456-0111
Get Directions

WOODLAND CLINIC LLC is a hospice and palliative medicine family medicine in Woodland, MS. The provider is a family medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care. WOODLAND CLINIC LLC NPI is 1629282330. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is Woodland Clinic Llc.

The provider's business location address is:

120 MARKET ST
WOODLAND, MS
ZIP 39776-104
Phone: (662) 456-0111
Fax: (662) 456-7335

The provider's authorized official is Jerry Sullivan .
The authorized official title is Owner and has the following contact phone number (662) 456-0111.

The enumeration date for this NPI number is 5/10/2007 and was last updated on 1/29/2011.


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
1207QH0002XFamily MedicineHospice and Palliative MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1258937MEDICARE OSCAR/CERTIFICATIONMISSISSIPPI
2C48284MEDICARE UPINMISSISSIPPI
3S69279MEDICARE UPINMISSISSIPPI
409014809MEDICAIDMISSISSIPPI
50114346MEDICAIDMISSISSIPPI
60112415MEDICAIDMISSISSIPPI

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

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