WOODLAND CLINIC LLC
NPI 1629282330
Family Medicine - Hospice and Palliative Medicine in Woodland, MS

NPI Status: Active since May 10, 2007

Contact Information

120 MARKET ST
WOODLAND, MS
ZIP 39776
Phone: (662) 456-0111
Fax: (662) 456-7335

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  • Organization
  • Family Medicine
  • Hospice and Palliative Medicine
  • Accepts Insurance

About WOODLAND CLINIC LLC

This page provides the complete NPI Profile along with additional information for Woodland Clinic Llc, a provider established in Woodland, Mississippi operating as a Family Medicine, focusing in hospice and palliative medicine . The healthcare provider is registered in the NPI registry with number 1629282330 assigned on May 2007. The practitioner's primary taxonomy code is 207QH0002X. The provider is registered as an organization and their NPI record was last updated 15 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's former legal business name is Woodland Clinic Llc. The authorized official of this NPI record is Jerry Sullivan (Owner)

NPI
1629282330
Provider Legal Name
WOODLAND CLINIC LLC
Other Organization Name
WOODLAND CLINIC LLC
Other Name Type
Former Legal Business Name (4)
Entity Type
Organization
Location Address
120 MARKET ST WOODLAND, MS 39776
Location Phone
(662) 456-0111
Location Fax
(662) 456-7335
Mailing Address
PO BOX 186 WOODLAND, MS 39776
Mailing Phone
(662) 456-0111
Mailing Fax
(662) 456-7335
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-10-2007
Last Update Date
01-29-2011
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine Hospice and Palliative Medicine

Taxonomy Code
207QH0002X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A family medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care.

Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA (QualChoice) - POS
  • Complete Gold - PPO
  • Complete Gold + Vision + Adult Dental - PPO
  • Complete Silver (QualChoice) - POS
  • Connected Silver - PPO
  • Connected Silver (QualChoice) - POS
  • Connected Silver (QualChoiceLife) - PPO
  • Connected Silver + Vision + Adult Dental - PPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Clear Silver - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Connect Bronze 5500 Indiv Med Deductible Enhanced Diabetes Care - EPO
  • Connect Bronze 6500 Indiv Med Deductible - EPO
  • Connect Bronze 8500 Indiv Med Deductible - EPO
  • Connect Bronze CMS Standard - EPO
  • Connect Gold 2000 Indiv Med Deductible - EPO
  • Connect Gold CMS Standard - EPO
  • Connect Silver 3800 Indiv Med Deductible Enhanced Diabetes Care - EPO
  • Connect Silver 4000 Indiv Med Deductible - EPO
  • Connect Silver 6500 Indiv Med Deductible - EPO
  • Connect Silver CMS Standard - EPO
  • Bronze 4 - HMO
  • Bronze 8 - HMO
  • Gold 1 - HMO
  • Gold 1 with Adult Vision Services - HMO
  • Gold 8 - HMO
  • Silver 1 - HMO
  • Silver 1 with Adult Vision Services - HMO
  • Silver 12 with First 4 Primary Care Visits Free - HMO
  • Silver 8 - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JERRY SULLIVAN

Authorized Official Title
OWNER
Authorized Official Phone
(662) 456-0111

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
258937MEDICARE OSCAR/CERTIFICATION (06)MS 
C48284MEDICARE UPIN (02)MS 
S69279MEDICARE UPIN (02)MS 
09014809MEDICAID (05)MS 
0114346MEDICAID (05)MS 
0112415MEDICAID (05)MS 

Reviews for WOODLAND CLINIC LLC

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1629282330
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
264948436
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 4 + 9 + 4 + 8 + 4 + 3 + 6 + 24 = 70
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1629282330 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1508072273FOOT SOLUTIONS LLC
Organization
Pharmacy (Clinic Pharmacy)120 MARKET ST
WOODLAND, MS 39776
(662) 456-0133
1407682420 JESSICA SULLIVAN CFNP
Individual
Nurse Practitioner (Primary Care)120 MARKET ST
WOODLAND, MS 39776
(662) 456-0111

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1629282330, enumerated in the NPI registry as an "organization" on May 10, 2007

The provider is located at 120 Market St Woodland, Ms 39776 and the phone number is (662) 456-0111

This medical organization specializes in Family Medicine with taxonomy code 207QH0002X with a focus in Hospice and Palliative Medicine

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

This NPI record was last updated on May 10, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.