Mission Primary Care Clinic PLLC
NPI 1487852018ActiveOrganization· Family Medicine· Vicksburg, MS
Family Medicine in Vicksburg, Mississippi, registered in NPPES in July 2007. The authorized official on file is Bill Fulcher, Adm. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1487852018 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 5, 2007 |
| Last updated in NPPES | May 25, 2022 |
| Certified by provider | May 25, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
| Nurse Practitioner, Family | 363LF0000X | R829001 | MS |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MS) |
|---|
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