Grayson Creek Medical Clinic, LLC
NPI 1184166035 · Pediatric Nurse Practitioner · Moselle, MS
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Grayson Creek Medical Clinic, LLC is a Pediatric Nurse Practitioner organization in Moselle, MS (NPI 1184166035).
Provider details
- NPI number
- 1184166035
- Entity type
- Organization
- Primary specialty
- Pediatric Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Mack Knight, Owner(601) 408-9945
- License
- 732001 (MS)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
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
9 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
Registry dates
- Enumerated
- 2016-11-09
- Last updated
- 2017-10-19
Frequently asked questions
- What is Grayson Creek Medical Clinic, LLC's NPI number?
- Grayson Creek Medical Clinic, LLC's National Provider Identifier (NPI) is 1184166035, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Grayson Creek Medical Clinic, LLC?
- Grayson Creek Medical Clinic, LLC is classified in the NPPES registry as Pediatric Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Grayson Creek Medical Clinic, LLC located?
- Grayson Creek Medical Clinic, LLC's practice location on file with NPPES is 3 John Everett Rd, Moselle, MS 39459-9771.
- What is Grayson Creek Medical Clinic, LLC's phone number?
- The practice phone number listed in the NPPES registry for Grayson Creek Medical Clinic, LLC is (601) 620-9991.
- Does Grayson Creek Medical Clinic, LLC accept Medicare?
- Grayson Creek Medical Clinic, LLC 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 Grayson Creek Medical Clinic, LLC?
- The authorized official listed on Grayson Creek Medical Clinic, LLC's NPPES record is Mack Knight, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Grayson Creek Medical Clinic, LLC's NPI active?
- Yes — Grayson Creek Medical Clinic, LLC's NPI (1184166035) is active in the NPPES registry as of the last update on 2017-10-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.