WHEELER FAMILY MEDICAL CLINIC – NPI #1770672339
Clinic/Center

WHEELER FAMILY MEDICAL CLINIC is an AHC clinic located in BOONEVILLE, MS. NPPES has assigned the NPI number 1770672339 to WHEELER FAMILY MEDICAL CLINIC on October 12, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “WHEELER FAMILY MEDICAL CLINIC” is a dba name, the actual legal business name for this organization is AMY BENJAMIN. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QR1300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Rural Health

The NPI profile was previously updated about 18 years ago on Jul 28, 2008. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for WHEELER FAMILY MEDICAL CLINIC below.

NPI Profile for
AMY BENJAMIN

NPI Number
1770672339
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
AMY BENJAMIN
Doing Business As (dba): WHEELER FAMILY MEDICAL CLINIC
Primary location
618 CR 5031
BOONEVILLE, MS 38829
Phone: (662) 365-0200 Fax: (662) 365-0199
Mailing address
PO BOX 95
WHEELER, MS 38880-0095
Phone: (662) 365-0200 Fax: (662) 365-0199
Organization Subpart
No
Authorized Official
MARIE TYUS
OFFICE MANAGER
Phone: (662) 365-0200
Updated
Identifiers

Identifiers for WHEELER FAMILY MEDICAL CLINIC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERCLINIC UPINC03567
OTHERMEDICAID GROUP04071559
MEDICAIDMS04071559
MEDICAIDMS03904817
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QR1300X
- Clinic/Center / Rural Health (Primary)
363LF0000X
- Nurse Practitioner / Family
MS R850588

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.