| Covington County Hospital | |
|
603 South Main Street Mt. Olive MS 39119-4945 | |
| (601) 797-3405 | |
| Not Available |
| Full Name | Covington County Hospital |
|---|---|
| Speciality | Clinic/Center |
| Location | 603 South Main Street, Mt. Olive, 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 Po Box 1107 Mount Olive MS 39119-4945 Ph: (601) 797-3405 | Covington County Hospital 603 South Main Street Mt. Olive MS 39119-4945 Ph: (601) 797-3405 |
| NPI Number | 1336447861 |
|---|---|
| Provider Enumeration Date | 03/08/2011 |
| Last Update Date | 10/05/2011 |
| Medicare PECOS PAC ID | 4183517253 |
|---|---|
| Medicare Enrollment ID | O20110519000619 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336447861 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Jeffrey J Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942234232 PECOS PAC ID: 1557311032 Enrollment ID: I20050124000631 |
| Provider Name | Mary S Watkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245323914 PECOS PAC ID: 3072610229 Enrollment ID: I20070522000691 |
| Provider Name | Word Johnston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952305567 PECOS PAC ID: 3173540358 Enrollment ID: I20100803000398 |
| 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 | Karen R Pitts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467729293 PECOS PAC ID: 7113193251 Enrollment ID: I20111220000631 |
| Provider Name | Brian K Padgett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750677704 PECOS PAC ID: 3173787702 Enrollment ID: I20120612000442 |
| 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 | 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 | Christie L Kellar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184161457 PECOS PAC ID: 6901183094 Enrollment ID: I20170427000044 |
| 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 | Anna Lisa Seals |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801372685 PECOS PAC ID: 4385992916 Enrollment ID: I20180730002204 |
| Provider Name | Twylia M. Aultman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912483405 PECOS PAC ID: 3072863000 Enrollment ID: I20180912001218 |
| 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 | 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 | Amanda Cooley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841723251 PECOS PAC ID: 6406120369 Enrollment ID: I20210625002693 |
| Provider Name | Weaton M Middleton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467022939 PECOS PAC ID: 3678970571 Enrollment ID: I20210920002548 |
| Provider Name | Nadia S Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689345506 PECOS PAC ID: 3870987787 Enrollment ID: I20220218000291 |
| 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 |
Green Tree Family Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 603 Main Street, Mt. Olive, MS 39119 Phone: 601-797-3405 Fax: 601-797-4707 |