Grenada Adult Healthcare Clinic PC.
NPI 1144478512 · Primary Care Clinic/Center · Grenada, MS
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Grenada Adult Healthcare Clinic PC. is a Primary Care Clinic/Center organization in Grenada, MS (NPI 1144478512).
Provider details
- NPI number
- 1144478512
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Justice Gondwe, President(662) 227-6450
- License
- 20373 (MS)
Specialties & taxonomies
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 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
Mailing address
Other names (DBA / former)
- Doing business as
- Grenada Adult Healthcare Clinic PC.
Registry dates
- Enumerated
- 2008-08-28
- Last updated
- 2008-08-29
Frequently asked questions
- What is Grenada Adult Healthcare Clinic PC.'s NPI number?
- Grenada Adult Healthcare Clinic PC.'s National Provider Identifier (NPI) is 1144478512, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Grenada Adult Healthcare Clinic PC.?
- Grenada Adult Healthcare Clinic PC. is classified in the NPPES registry as Primary Care Clinic/Center (Ambulatory Health Care Facilities).
- Where is Grenada Adult Healthcare Clinic PC. located?
- Grenada Adult Healthcare Clinic PC.'s practice location on file with NPPES is 965 J K Avent Dr, Grenada, MS 38901-5045.
- What is Grenada Adult Healthcare Clinic PC.'s phone number?
- The practice phone number listed in the NPPES registry for Grenada Adult Healthcare Clinic PC. is (662) 227-6450.
- Does Grenada Adult Healthcare Clinic PC. accept Medicare?
- Grenada Adult Healthcare Clinic PC. 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 Grenada Adult Healthcare Clinic PC.?
- The authorized official listed on Grenada Adult Healthcare Clinic PC.'s NPPES record is Justice Gondwe, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Grenada Adult Healthcare Clinic PC.'s NPI active?
- Yes — Grenada Adult Healthcare Clinic PC.'s NPI (1144478512) is active in the NPPES registry as of the last update on 2008-08-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.