Vicksburg Clinic LLC in Vicksburg, MS
This location of Vicksburg Clinic bills under NPI 1174494975, an organization record issued on Sep 15, 2025 with the primary taxonomy Rural Health Clinic/Center. It is one of 11 NPIs registered under this name and one of 9 in Vicksburg; each clinician who sees you there has their own NPI and license.
- Legal name
- Vicksburg Clinic LLC
- Entity
- Type 2 · organization, a subpart
- Parent organization
- Vicksburg Clinic LLC
- Primary taxonomy
- Rural Health Clinic/Center 261QR1300X
- Practice location
- 3317 PEMBERTON SQUARE BLVD, Vicksburg, MS 39180
- Phone
- 601-636-1173
- Mailing address
- Franklin, TN
- Enumerated
- Sep 15, 2025
- Record updated
- Sep 15, 2025
- Authorized official
- Director Provider Enrollment / Ao (title as filed)
The other 8 Vicksburg NPIs
- Vicksburg Clinic LLC1115 N FRONTAGE RD · issued Jun 23, 20061659307791
- Vicksburg Clinic LLC2100 HIGHWAY 61 N · issued Jun 25, 20061790711158
- Vicksburg Clinic LLC2100 HIGHWAY 61 N · issued Jul 17, 20061992722482
- Vicksburg Clinic LLC1115 N FRONTAGE RD · issued May 24, 20071154532257
- Vicksburg Clinic LLC2100 HIGHWAY 61 N · issued Jul 17, 20091790915395
- Vicksburg Clinic LLC1907 MISSION 66 · issued Jul 17, 20091528298122
- Vicksburg Clinic LLC2200 HIGHWAY 61 N · issued Jul 20, 20091861622268
- Vicksburg Clinic LLC1 MEDICAL PLAZA DR · issued May 14, 20151619355203
20 clinicians CMS lists with Vicksburg Clinic in Vicksburg
- Gustavo Barrazueta, MDOrthopaedic Surgery Physician1154701670
- Ramon Caballero, MDUrology Physician1851480453
- Salena Cecil, APRNWomen's Health Nurse Practitioner1992122394
- John Fagan, MDUrology Physician1801827019
- Feras Hamadeh, MDPulmonary Disease Physician1518051705
- Declan Hegarty, MDSurgery Physician1477526945
- Sidney Johnson, MDRadiation Oncology Physician1497757603
- Niyazi KilicObstetrics & Gynecology Physician1972096113
- Kimberly Kilpatrick, CFNPFamily Nurse Practitioner1881146306
- Miranda Mccaskill, AUDAudiologist1821431990
- Joyce Muruthi, MDObstetrics & Gynecology Physician1255777025
- Paul Pierce, MDCardiovascular Disease Physician1821005265
- Shelby Primeaux, MSN, APRN, AGACNP-BCNurse Practitioner1942870910
- Adam Protos, MDSurgery Physician1629383922
- Ashley RiggsFamily Nurse Practitioner1760296966
- Thomas Sligh, MDInternal Medicine Physician1811928005
- Erica Smith, PA-C, ATCPhysician Assistant1477013456
- James Stanford, MDOtolaryngology Physician1063866705
- Brandon Teller, FNP-CFamily Nurse Practitioner1285477018
- Christopher Tipton, MDOrthopaedic Surgery Physician1801282223
Source: CMS Doctors and Clinicians group affiliations, matched by practice name and city.
Every location registered under this name, in 3 cities.
See every locationChecking an organization
- Confirm the business with the Mississippi secretary of state.
- Check the HHS-OIG exclusion list for the organization.
- Verify each clinician on their own record and the state license search.
Common questions
Why is the mailing address in Tennessee?
The mailing address in the record (Franklin, TN) is where the organization receives mail. Care is given at the practice location in Vicksburg.
What does subpart mean?
The organization registered this NPI as a subpart: a part of the organization, such as a location, that bills under its own NPI.
Is an organization NPI a license?
No. An NPI identifies who bills. Facilities and the clinicians who work there are licensed separately by the state.
Which Vicksburg NPI should I use?
Ask the office which NPI it bills under; all 9 Vicksburg NPIs are registered under the same name.
Source: CMS National Plan and Provider Enumeration System (NPPES), monthly file of Aug 9, 2026 (NPPES files on CMS.gov). An NPI identifies who bills; it is not a license.