| Covington County Hospital | |
|
701 S Holly Ave Collins MS 39428-3894 | |
| (601) 765-2746 | |
| (601) 765-6660 |
| Full Name | Covington County Hospital |
|---|---|
| Speciality | Clinic/Center |
| Location | 701 S Holly Ave, Collins, Mississippi |
| Authorized Official Name and Position | Kirstie Evans (CFO) |
| Authorized Official Contact | 6017656711 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Covington County Hospital 210 Main St Collins MS 39428-6188 Ph: (601) 765-2746 | Covington County Hospital 701 S Holly Ave Collins MS 39428-3894 Ph: (601) 765-2746 |
| NPI Number | 1518260330 |
|---|---|
| Provider Enumeration Date | 12/16/2010 |
| Last Update Date | 12/16/2010 |
| Medicare PECOS PAC ID | 4183517253 |
|---|---|
| Medicare Enrollment ID | O20040203000816 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518260330 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Terry D Ford |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912922949 PECOS PAC ID: 2961398102 Enrollment ID: I20040225000436 |
| Provider Name | Roseline K Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205912946 PECOS PAC ID: 0244228112 Enrollment ID: I20040501000174 |
| Provider Name | Becky J Mercier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083726491 PECOS PAC ID: 0244216166 Enrollment ID: I20040629001303 |
| Provider Name | Charles L Mccullouch |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710964754 PECOS PAC ID: 8729066923 Enrollment ID: I20040713001089 |
| Provider Name | Leigh P Drace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013064245 PECOS PAC ID: 3375512916 Enrollment ID: I20040929001220 |
| Provider Name | Evan J Pickus |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073545554 PECOS PAC ID: 3375501471 Enrollment ID: I20041221000439 |
| Provider Name | Roger L Nunez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932132669 PECOS PAC ID: 4284692617 Enrollment ID: I20041230000547 |
| Provider Name | Jeffrey J Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942234232 PECOS PAC ID: 1557311032 Enrollment ID: I20050124000631 |
| Provider Name | Sherri A Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790894335 PECOS PAC ID: 8921042318 Enrollment ID: I20050616000410 |
| Provider Name | David L Jameson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982669636 PECOS PAC ID: 8628096401 Enrollment ID: I20051110000174 |
| Provider Name | Toikus Westbrook |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285738468 PECOS PAC ID: 1153348362 Enrollment ID: I20061009000262 |
| Provider Name | Robin D Greene - Brownlee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215035985 PECOS PAC ID: 8628078425 Enrollment ID: I20061229000186 |
| Provider Name | Herbert Floyd |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457345365 PECOS PAC ID: 8426154923 Enrollment ID: I20070430000363 |
| Provider Name | Mary S Watkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245323914 PECOS PAC ID: 3072610229 Enrollment ID: I20070522000691 |
| Provider Name | George E Gillespie |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1124117171 PECOS PAC ID: 4082713151 Enrollment ID: I20070702000147 |
| Provider Name | Chad D Caraway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205052164 PECOS PAC ID: 9436232170 Enrollment ID: I20080219000084 |
| Provider Name | Marshall J Stout |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073555454 PECOS PAC ID: 3072682707 Enrollment ID: I20080520000765 |
| Provider Name | Kiley Mclendon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780849109 PECOS PAC ID: 7113095407 Enrollment ID: I20081014000670 |
| Provider Name | William B Gibboney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225202864 PECOS PAC ID: 1153481916 Enrollment ID: I20081124000457 |
| Provider Name | Andrea M Bruce |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295739894 PECOS PAC ID: 8426113135 Enrollment ID: I20090212000523 |
| Provider Name | Jennifer B Boutwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184958969 PECOS PAC ID: 5698815439 Enrollment ID: I20091229000564 |
| Provider Name | Jonathan C Sledge |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982868782 PECOS PAC ID: 9638214042 Enrollment ID: I20100309000597 |
| Provider Name | Harpreet Sood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336398510 PECOS PAC ID: 6002932191 Enrollment ID: I20100927000395 |
| Provider Name | Jennifer R Leggett-hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801100037 PECOS PAC ID: 3476748427 Enrollment ID: I20101116000588 |
| Provider Name | Haresh M Patel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1659339125 PECOS PAC ID: 1658275219 Enrollment ID: I20110321000581 |
| Provider Name | Jessica A Garner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982913729 PECOS PAC ID: 2466635438 Enrollment ID: I20110329000471 |
| Provider Name | Patricia A Bullock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679862817 PECOS PAC ID: 1557530128 Enrollment ID: I20110816000741 |
| Provider Name | Jeremy Paul Wade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538494489 PECOS PAC ID: 6406029487 Enrollment ID: I20111108000436 |
| Provider Name | Karen R Pitts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467729293 PECOS PAC ID: 7113193251 Enrollment ID: I20111220000631 |
| Provider Name | Christa Kay Staples |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740319839 PECOS PAC ID: 1759549025 Enrollment ID: I20120217000036 |
| Provider Name | Brian K Padgett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750677704 PECOS PAC ID: 3173787702 Enrollment ID: I20120612000442 |
| Provider Name | Terri Bickham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457668162 PECOS PAC ID: 7911131768 Enrollment ID: I20131009001742 |
| Provider Name | Tyler W Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639501380 PECOS PAC ID: 5496980880 Enrollment ID: I20131018001537 |
| Provider Name | Erin K Hines |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952742736 PECOS PAC ID: 3779712799 Enrollment ID: I20140214000449 |
| Provider Name | Wendell T Carney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043638869 PECOS PAC ID: 2961628805 Enrollment ID: I20140729002044 |
| Provider Name | Nicole Lott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861809402 PECOS PAC ID: 8628297959 Enrollment ID: I20140917002925 |
| Provider Name | Lacey Blakeney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326457151 PECOS PAC ID: 7214254010 Enrollment ID: I20150316000467 |
| Provider Name | Norman E Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992196331 PECOS PAC ID: 9830416908 Enrollment ID: I20150330001257 |
| Provider Name | Michael R Ambrose |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427023696 PECOS PAC ID: 3971406729 Enrollment ID: I20150427001574 |
| Provider Name | David J Mulvaney |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578509659 PECOS PAC ID: 0446294565 Enrollment ID: I20150501001415 |
| Provider Name | Katie Rush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891183208 PECOS PAC ID: 6204156821 Enrollment ID: I20150528000034 |
| Provider Name | Melissa Coulson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235581513 PECOS PAC ID: 8729371737 Enrollment ID: I20160728002112 |
| Provider Name | Benjamin Michael Illich |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508277609 PECOS PAC ID: 4981929015 Enrollment ID: I20170208000775 |
| Provider Name | Christie L Kellar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184161457 PECOS PAC ID: 6901183094 Enrollment ID: I20170427000044 |
| Provider Name | Bryan G Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255731287 PECOS PAC ID: 3870815731 Enrollment ID: I20171213002890 |
| Provider Name | Natalie R Keyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285144584 PECOS PAC ID: 6608137971 Enrollment ID: I20180301000326 |
| Provider Name | Crystal P Mcnabb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326565763 PECOS PAC ID: 5193086403 Enrollment ID: I20180301001879 |
| Provider Name | Terri Byrd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285135228 PECOS PAC ID: 4284983875 Enrollment ID: I20180815000482 |
| Provider Name | Twylia M. Aultman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912483405 PECOS PAC ID: 3072863000 Enrollment ID: I20180912001218 |
| Provider Name | Laura J Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548756810 PECOS PAC ID: 1850644618 Enrollment ID: I20181024000654 |
| Provider Name | Sarah D Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922582220 PECOS PAC ID: 3779836325 Enrollment ID: I20181029000792 |
| Provider Name | Felicia S Stewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477011161 PECOS PAC ID: 9830431444 Enrollment ID: I20190501001619 |
| Provider Name | Bria Goff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457904989 PECOS PAC ID: 4688906183 Enrollment ID: I20191104000414 |
| Provider Name | Anna Fails |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154945848 PECOS PAC ID: 5193147007 Enrollment ID: I20200623002065 |
| Provider Name | Ariale Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790319945 PECOS PAC ID: 8527481845 Enrollment ID: I20200706000808 |
| Provider Name | Destiny D Epting |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710598230 PECOS PAC ID: 5193141539 Enrollment ID: I20200817002458 |
| Provider Name | Holly K Odom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790392850 PECOS PAC ID: 4082033626 Enrollment ID: I20200930002077 |
| Provider Name | Samantha C Givens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497356562 PECOS PAC ID: 8820401888 Enrollment ID: I20210112000722 |
| Provider Name | Brandon Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639746001 PECOS PAC ID: 0547662025 Enrollment ID: I20210706003239 |
| Provider Name | Jeremy Todd Unger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881198075 PECOS PAC ID: 2163772484 Enrollment ID: I20210920000924 |
| Provider Name | Weaton M Middleton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467022939 PECOS PAC ID: 3678970571 Enrollment ID: I20210920002548 |
| Provider Name | Jacob Warren Spring |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255946018 PECOS PAC ID: 4284026386 Enrollment ID: I20220124000770 |
| Provider Name | Nadia S Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689345506 PECOS PAC ID: 3870987787 Enrollment ID: I20220218000291 |
| Provider Name | Carley Daigle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841922937 PECOS PAC ID: 4688055908 Enrollment ID: I20220718003871 |
| Provider Name | Shelby Dickerson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457116907 PECOS PAC ID: 2668813841 Enrollment ID: I20240520000588 |
| Provider Name | Terrie S Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073334975 PECOS PAC ID: 1052832730 Enrollment ID: I20250317001218 |
Covington County Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3275 Hwy 49, Suite E, Collins, MS 39428 Phone: 601-765-6711 Fax: 601-765-2808 | |
Southeast Mississippi Rural Health Initiative, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 Carver Drive, Collins, MS 39428 Phone: 601-545-8700 Fax: 601-450-2493 | |
Covington County Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 S Holly Ave, Collins, MS 39428 Phone: 601-765-6711 Fax: 601-698-0112 | |
Covington County Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1207 S Fir Ave, Collins, MS 39428 Phone: 601-419-7468 | |
Hattiesburg Clinic Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 704 Fifth Street, Collins, MS 39428 Phone: 601-765-4414 Fax: 601-765-9141 | |
Covington County Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 Highway 35, Collins, MS 39428 Phone: 601-837-7380 | |
Southeast Mississippi Rural Health Initiative, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 824 Hopewell Rd, Collins, MS 39428 Phone: 601-545-8700 Fax: 601-450-2493 |