Walnut Grove Clinic - Medicare Primary Care in Walnut Grove, MS

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Walnut Grove Clinic is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Walnut Grove, Mississippi. The current practice location for Walnut Grove Clinic is 199 Rimmer St, Walnut Grove, Mississippi. For appointments, you can reach them via phone at (601) 253-2733. The mailing address for Walnut Grove Clinic is Po Box 142, Sebastopol, Mississippi and phone number is (601) 625-7140.

Walnut Grove Clinic is licensed to practice in (license number ). The clinic also participates in the medicare program and its NPI number is 1255387619. 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 (601) 253-2733.

Contact Information

Walnut Grove Clinic
199 Rimmer St
Walnut Grove
MS 39189
(601) 253-2733
(601) 253-2733

Map and Direction


Primary Care Clinic Profile

Full NameWalnut Grove Clinic
SpecialityClinic/Center
Location199 Rimmer St, Walnut Grove, Mississippi
Authorized Official Name and PositionJill Bishop (CEO)
Authorized Official Contact6016257140
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Walnut Grove Clinic
Po Box 142
Sebastopol
MS 39359

Ph: (601) 625-7140		Walnut Grove Clinic
199 Rimmer St
Walnut Grove
MS 39189

Ph: (601) 253-2733

NPI Details:

NPI Number1255387619
Provider Enumeration Date05/26/2006
Last Update Date04/24/2025
Certification Date04/24/2025

Medicare PECOS Information:

Medicare PECOS PAC ID0941103717
Medicare Enrollment IDO20040129000363

Medical Identifiers

Medical identifiers for Walnut Grove Clinic such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1255387619NPI-NPPES
09013670MedicaidMS
DA1146OtherRAILROAD MEDICARE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QF0400XClinic/center - Federally Qualified Health Center (fqhc) ()Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Walnut Grove Clinic acts as a billing entity for following providers:
Provider NameJames W Lock
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1063499002
PECOS PAC ID: 3577542406
Enrollment ID: I20040715000296
Provider NameMary E Spreafico
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1104036177
PECOS PAC ID: 8729172010
Enrollment ID: I20070918000038
Provider NameKayti Powell
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730340563
PECOS PAC ID: 2860560695
Enrollment ID: I20081007000582
Provider NameKeisha L Oliphant
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1679710933
PECOS PAC ID: 5698830222
Enrollment ID: I20090216000324
Provider NameKaren Reece
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1609853647
PECOS PAC ID: 0345370482
Enrollment ID: I20100616000128
Provider NameClaudia Bowman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1174892822
PECOS PAC ID: 3476712712
Enrollment ID: I20120306000964
Provider NameAmber S Riley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1841538030
PECOS PAC ID: 5890921035
Enrollment ID: I20131119000374
Provider NameWendy D Gressett
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1689096505
PECOS PAC ID: 6103049259
Enrollment ID: I20140519001718
Provider NameTelitha K Grant-spencer
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1851570006
PECOS PAC ID: 1658447891
Enrollment ID: I20161111000595
Provider NameGaydon Nowell
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1205355781
PECOS PAC ID: 2961778220
Enrollment ID: I20171101001228
Provider NameMary R Thomas
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1881241123
PECOS PAC ID: 3678804309
Enrollment ID: I20191011000011
Provider NameGloria a Graham
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1932519964
PECOS PAC ID: 0244506764
Enrollment ID: I20201102001873
Provider NameAmanda Cooley
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1841723251
PECOS PAC ID: 6406120369
Enrollment ID: I20210625002693
Provider NameAnna K Woods
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1912686296
PECOS PAC ID: 7214390053
Enrollment ID: I20230828002027
Provider NameKathy Gray
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1952548646
PECOS PAC ID: 9830547066
Enrollment ID: I20240517000730
Provider NameCandace Tierra Pearson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1467272344
PECOS PAC ID: 8921534470
Enrollment ID: I20250424000978
Provider NameSadie K. Marshall
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1093494015
PECOS PAC ID: 7315395456
Enrollment ID: I20251020002274

Reviews and Comments

Other Primary Care Clinics in Walnut Grove, MS

Walnut Grove Medical Associates
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 110 Park St, Walnut Grove, MS 39189
Phone: 601-253-0173    Fax: 601-253-0176
Bmc Leake Walnut Grove Primary Care
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Medicare: Medicare Enrolled
Practice Location: 110 Park St, Walnut Grove, MS 39189
Phone: 601-267-1400    
Bmc Leake Madden Primary Care
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Medicare: Medicare Enrolled
Practice Location: 17509 Highway 21, Walnut Grove, MS 39189
Phone: 601-267-1320    

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.