Prime Care Clinic of Clinton, LLC
NPI 1790444263ActiveOrganization· Nurse Practitioner, Adult Health· Clinton, MS
Nurse Practitioner, Adult Health in Clinton, Mississippi, registered in NPPES in December 2021. The authorized official on file is Justin C. Jackson, Member/Coo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1790444263 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 13, 2021 |
| Last updated in NPPES | Jan 25, 2022 |
| Certified by provider | Jan 25, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Adult Health Primary | 363LA2200X | — | — |
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) |
|---|
Other adult health nurse practitioners in Clinton
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