Grayson Creek Medical Clinic, LLC
NPI 1184166035ActiveOrganization· Nurse Practitioner, Pediatrics· Moselle, MS
Nurse Practitioner, Pediatrics in Moselle, Mississippi, registered in NPPES in November 2016. The authorized official on file is Mack E. Knight, FNP-C, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1184166035 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 9, 2016 |
| Last updated in NPPES | Oct 19, 2017 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Pediatrics Primary | 363LP0200X | 732001 | MS |
| Nurse Practitioner, Family | 363LF0000X | 732001 | MS |
| Nurse Practitioner, Family | 363LF0000X | 901749 | MS |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MS) |
|---|