Divinity Pediatric Clinic, Pllc
LBN: Divinity Pediatric Clinic, Pllc
Divinity Pediatric Clinic, Pllc is an health care organization with primary practice located at 200 Riverwind Dr Ste 104 , Pearl MS 39208-5652. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is the primary health care specialty.
Divinity Pediatric Clinic, Pllc can be contacted via phone (601) 345-4044, or through Mccoy, Rekita D. via phone (601) 345-4044.
Contact Information
Primary practice address
200 Riverwind Dr Ste 104
Pearl MS 39208-5652
Phone: (601) 345-4044
Fax: (601) 510-9334
Website:
Authorized official contact:
Name: Mccoy, Rekita D. Family Nurse Practitioner (FNP)
Phone: (601) 345-4044
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X |
Profile Details
| NPI number | 1629741152 |
|---|---|
| LBN Legal business name | Divinity Pediatric Clinic, Pllc |
| DBA Doing business as | |
| Authorized official | Mccoy, Rekita D. Family Nurse Practitioner (FNP) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 29th, 2021 |
| Last updated | Sep 3rd, 2022 - about 3 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629741152 | NPPES |
| Mississippi | MEDICAID | 1629741152 |
Popular Providers
-
Marybeth Nayfield
3700 W Sovereign Path , Lecanto FL 34461-8071 -
Comprehensive Medical Care, P.C.
6918 Shallowford Rd Suite 206, Chattanooga TN 37421-6784 -
Mcleod Physician Associates Ii
204 E Cheves St , Florence SC 29506-2604 -
Oak West Health Center
4201 Brook Spring Dr Oak West Health Center, Dallas TX 75224-4938 -
Faith Pediatrics And Adolescent Medicine Inc.
3350 Six Forks Rd , Raleigh NC 27609-7233 -
Pediatrics Primary Care Clinic (Ppcc)
6303 Harry Hines Blvd Pediatrics Primary Care Clinic (Ppcc), Dallas TX 75235-5228 -
East Hartford Medical Center Inc
580 Burnside Avenue Suite 4, East Hartford CT 06108 -
Ocala Oncology Center Pl
3130 Sw 32Nd Ave , Ocala FL 34474-4445