OrganizationActive
Grenada Lake Medical Center
NPI 1134302136 · Clinic/Center · Grenada, MS
Grenada Lake Medical Center is a Clinic/Center organization in Grenada, MS (NPI 1134302136).
Provider details
- NPI number
- 1134302136
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Charles Denton, Ceo(662) 227-7000
- License
- 11-245 (MS)
Specialties & taxonomies
Ambulatory Health Care Facilities
Hospitals
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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
965 Avent Dr Ste 105
Grenada, MS 38901-5045
Phone: (662) 227-7575
Approximate (ZIP-level) locationGet directions
Mailing address
965 Avent Dr Ste 105
Grenada, MS 38901-5045
Other names (DBA / former)
- Doing business as
- Grenada Primary Care Clinic
Registry dates
- Enumerated
- 2007-12-12
- Last updated
- 2007-12-17
Frequently asked questions
- What is Grenada Lake Medical Center's NPI number?
- Grenada Lake Medical Center's National Provider Identifier (NPI) is 1134302136, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Grenada Lake Medical Center?
- Grenada Lake Medical Center is classified in the NPPES registry as Clinic/Center (Ambulatory Health Care Facilities).
- Where is Grenada Lake Medical Center located?
- Grenada Lake Medical Center's practice location on file with NPPES is 965 Avent Dr Ste 105, Grenada, MS 38901-5045.
- What is Grenada Lake Medical Center's phone number?
- The practice phone number listed in the NPPES registry for Grenada Lake Medical Center is (662) 227-7575.
- Who is the authorized official for Grenada Lake Medical Center?
- The authorized official listed on Grenada Lake Medical Center's NPPES record is Charles Denton, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Grenada Lake Medical Center's NPI active?
- Yes — Grenada Lake Medical Center's NPI (1134302136) is active in the NPPES registry as of the last update on 2007-12-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.