| Rapha Wellness and Primary Care, LLC | |
|
140 Daughdrill Sta Flowood MS 39232-8406 | |
| (601) 965-9400 | |
| (601) 965-9418 |
| Full Name | Rapha Wellness and Primary Care, LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 140 Daughdrill Sta, Flowood, Mississippi |
| Authorized Official Name and Position | Natalie Michelle Alexander (PAYROLL AND ACCOUNTS SPECIALIST) |
| Authorized Official Contact | 6019659400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rapha Wellness and Primary Care, LLC 140 Daughdrill Sta Flowood MS 39232-8406 Ph: (601) 965-9400 | Rapha Wellness and Primary Care, LLC 140 Daughdrill Sta Flowood MS 39232-8406 Ph: (601) 965-9400 |
| NPI Number | 1457051591 |
|---|---|
| Provider Enumeration Date | 03/07/2023 |
| Last Update Date | 08/12/2025 |
| Certification Date | 08/12/2025 |
| Medicare PECOS PAC ID | 9830539261 |
|---|---|
| Medicare Enrollment ID | O20240501003470 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457051591 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| Provider Name | Melissa Harrell Mckissack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538497334 PECOS PAC ID: 7911035324 Enrollment ID: I20100505000742 |
| Provider Name | James M Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639418486 PECOS PAC ID: 5092953315 Enrollment ID: I20130529000004 |
| Provider Name | Karen H Bedells |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063898633 PECOS PAC ID: 4880903426 Enrollment ID: I20151021001069 |
| Provider Name | Jessica M Tolar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326689662 PECOS PAC ID: 3173917259 Enrollment ID: I20220307001845 |
| Provider Name | Sonya Newsome |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275231565 PECOS PAC ID: 1153855739 Enrollment ID: I20241106000602 |
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