Mississippi Medical Clinic
NPI 1114694536 · Family Nurse Practitioner · Taylorsville, MS
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Mississippi Medical Clinic is a Family Nurse Practitioner organization in Taylorsville, MS (NPI 1114694536).
Provider details
- NPI number
- 1114694536
- Entity type
- Organization
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Patty Bullock, NP Managing Partner(601) 452-7080
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 2170 Simpson Hwy 49Mendenhall, MS 39114Phone: (601) 452-7080
Registry dates
- Enumerated
- 2021-08-24
- Last updated
- 2022-04-25
- Certified
- 2022-04-11
Frequently asked questions
- What is Mississippi Medical Clinic's NPI number?
- Mississippi Medical Clinic's National Provider Identifier (NPI) is 1114694536, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mississippi Medical Clinic?
- Mississippi Medical Clinic is classified in the NPPES registry as Family Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Mississippi Medical Clinic located?
- Mississippi Medical Clinic's practice location on file with NPPES is 403 Pine St, Taylorsville, MS 39168-5659.
- What is Mississippi Medical Clinic's phone number?
- The practice phone number listed in the NPPES registry for Mississippi Medical Clinic is (601) 452-7080.
- Does Mississippi Medical Clinic accept Medicare?
- Mississippi Medical Clinic is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Mississippi Medical Clinic?
- The authorized official listed on Mississippi Medical Clinic's NPPES record is Patty Bullock, NP Managing Partner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mississippi Medical Clinic's NPI active?
- Yes — Mississippi Medical Clinic's NPI (1114694536) is active in the NPPES registry as of the last update on 2022-04-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.