Kosciusko Medical Clinic - Medicare Primary Care in Kosciusko, MS

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Kosciusko Medical Clinic is a medicare enrolled primary clinic (Clinic/center) in Kosciusko, Mississippi. The current practice location for Kosciusko Medical Clinic is 332 Highway 12 W, Kosciusko, Mississippi. For appointments, you can reach them via phone at (662) 289-1800. The mailing address for Kosciusko Medical Clinic is Po Box 23996, Jackson, Mississippi and phone number is (601) 206-6100.

Kosciusko Medical Clinic is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1790827038. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (662) 289-1800.

Contact Information

Kosciusko Medical Clinic
332 Highway 12 W
Kosciusko
MS 39090-3209
(662) 289-1800
Not Available

Map and Direction


Primary Care Clinic Profile

Full NameKosciusko Medical Clinic
SpecialityClinic/Center
Location332 Highway 12 W, Kosciusko, Mississippi
Authorized Official Name and PositionJackey D Turner (MEDICAL DIRECTOR)
Authorized Official Contact6622891800
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kosciusko Medical Clinic
Po Box 23996
Jackson
MS 39225-3996

Ph: (601) 206-6100		Kosciusko Medical Clinic
332 Highway 12 W
Kosciusko
MS 39090-3209

Ph: (662) 289-1800

NPI Details:

NPI Number1790827038
Provider Enumeration Date02/13/2007
Last Update Date10/02/2008

Medicare PECOS Information:

Medicare PECOS PAC ID8729973623
Medicare Enrollment IDO20040219000254

Medical Identifiers

Medical identifiers for Kosciusko Medical Clinic such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1790827038NPI-NPPES
09015162MedicaidMS
CG1185OtherMSRAILROAD MEDICARE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261Q00000XClinic/center (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Kosciusko Medical Clinic acts as a billing entity for following providers:
Provider NameMichael Holman
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1073576070
PECOS PAC ID: 3476548462
Enrollment ID: I20040419000888
Provider NameBenjamin T Carter
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1902868961
PECOS PAC ID: 1759366214
Enrollment ID: I20040621000526
Provider NameBrady L Richardson
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1598728586
PECOS PAC ID: 9335127562
Enrollment ID: I20040713000576
Provider NameChristi Sims
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1114956620
PECOS PAC ID: 6709864903
Enrollment ID: I20040713001044
Provider NameJames J Withers
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1295815462
PECOS PAC ID: 7719957620
Enrollment ID: I20040728001137
Provider NameD Stanley Hartness
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1831152164
PECOS PAC ID: 6608837034
Enrollment ID: I20041020000217
Provider NameMichelle S Atkinson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1154355428
PECOS PAC ID: 0547218729
Enrollment ID: I20050104000873
Provider NameDorothy Fulgham
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1497718399
PECOS PAC ID: 8527011386
Enrollment ID: I20050222000487
Provider NameDeidra Cockroft
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1265495154
PECOS PAC ID: 8921051608
Enrollment ID: I20050222000714
Provider NameRay Cockroft
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1881658359
PECOS PAC ID: 9133172711
Enrollment ID: I20050223000465
Provider NameTimothy M South
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1376506741
PECOS PAC ID: 6103871967
Enrollment ID: I20050315000702
Provider NameRobert G Browning
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1073585824
PECOS PAC ID: 9436119609
Enrollment ID: I20050701000725
Provider NameTimothy J Alford
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1023070067
PECOS PAC ID: 3577569094
Enrollment ID: I20061005000564
Provider NameLinda B Cockroft
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1477753929
PECOS PAC ID: 1153418884
Enrollment ID: I20071029000164
Provider NameRandi A Watkins
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1669635926
PECOS PAC ID: 1557435872
Enrollment ID: I20080805000622
Provider NameCindy M Johnson
Provider TypePractitioner - Qualified Audiologist
Provider IdentifiersNPI Number: 1386807709
PECOS PAC ID: 9638231970
Enrollment ID: I20081222000310
Provider NameTeresa I Schweitzer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1194050153
PECOS PAC ID: 6901939214
Enrollment ID: I20100805001091
Provider NameCrystal H Martin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1275869950
PECOS PAC ID: 9133245699
Enrollment ID: I20100922000464
Provider NameKimberly C Agent
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1871805820
PECOS PAC ID: 9537353297
Enrollment ID: I20101027000689
Provider NameKrista B Blaylock
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1609178094
PECOS PAC ID: 9739376484
Enrollment ID: I20101208000224
Provider NameBreck Richardson
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1962645770
PECOS PAC ID: 6507012333
Enrollment ID: I20120810000440
Provider NameJohn G Wallace
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1831486596
PECOS PAC ID: 3072756808
Enrollment ID: I20130827000525
Provider NameSamuel Holdiness
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1942595202
PECOS PAC ID: 8729243084
Enrollment ID: I20150821014005
Provider NameHannah Cooper
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1649653775
PECOS PAC ID: 7618286386
Enrollment ID: I20151020000933
Provider NameAmber Atkinson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1417309147
PECOS PAC ID: 2860771094
Enrollment ID: I20161110002461
Provider NameRobert Kirtis Greenlee
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1710401575
PECOS PAC ID: 5991070625
Enrollment ID: I20171006000049
Provider NameSarah Putt
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1144736885
PECOS PAC ID: 5799045175
Enrollment ID: I20180202000900
Provider NameAllison Langford
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1528551579
PECOS PAC ID: 4082960869
Enrollment ID: I20180710000266
Provider NameKayla B Ferguson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1437624566
PECOS PAC ID: 4183978885
Enrollment ID: I20181115002428
Provider NameEmily Cook Gross
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1588209530
PECOS PAC ID: 6002241619
Enrollment ID: I20200108001384
Provider NameCandice Edwards Parish
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1659905271
PECOS PAC ID: 9133519697
Enrollment ID: I20211124001363
Provider NameMeagan Morgan Carpenter
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1770295735
PECOS PAC ID: 9739550286
Enrollment ID: I20230120002119
Provider NameLatasha R Washington
Provider TypePractitioner - Qualified Speech Language Pathologist
Provider IdentifiersNPI Number: 1710220322
PECOS PAC ID: 0143682237
Enrollment ID: I20230822002241
Provider NameCarlie Savannah Payton-rutledge
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1487257515
PECOS PAC ID: 7517379407
Enrollment ID: I20231102001136

Reviews and Comments


Clinic/Center in Kosciusko, MS

Bmc Attala Kosciusko Primary Care
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 220 Highway 12 W, Kosciusko, MS 39090
Phone: 662-289-4311    Fax: 662-290-3255
Trace Medical Clinic
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 530 Veterans Memorial Dr, Kosciusko, MS 39090
Phone: 662-289-9155    Fax: 662-289-7752
Trace Medical Clinic, Pllc
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 530 Veterans Memorial Dr, Kosciusko, MS 39090
Phone: 662-289-9155    Fax: 662-289-7752
Fast Pace Mississippi, Pllc
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 50 Veterans Memorial Dr, Kosciusko, MS 39090
Phone: 931-253-1101    Fax: 931-722-9919

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.