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CHOCTAW MEDICAL CLINIC
NPI 1003223306
Clinic/Center - Rural Health in Ackerman, MS

Active since July 18, 2014CLIA Certified · 3 labs
1/5
Overall Rating
8613 MS HIGHWAY 12, ACKERMAN, MS 39735(662) 285-4400 Get Directions Write a Review

NPPES record last updated: May 3, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 3, 2022, Mar 10, 2020 (2 updates tracked since 2020).

About Choctaw Medical Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHOCTAW MEDICAL CLINIC (NPI 1003223306) is a healthcare organization registered as a rural health in Ackerman, Mississippi and active in the NPI registry since July 2014. The organization holds 3 active CLIA laboratory certificates and lists Susan Hollingsworth Wells, Administrator, as its authorized official.

NPPES Registry Identity

NPI1003223306
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameCHOCTAW REGIONAL MEDICAL CENTER
Location Address8613 MS HIGHWAY 12Ackerman, MS 39735-8917
Mailing Address8613 Ms Hwy 12 Campus Clinic Suite BAckerman, MS 39735-0719 · (662) 285-9460 · Fax (662) 285-9324
Phone(662) 285-4400
Organization SubpartNo
Authorized OfficialSusan Hollingsworth WellsAdministrator · (662) 285-9460
Enumeration DateJuly 18, 2014
Last NPPES UpdateMay 3, 20222 updates tracked since enumeration
NPPES CertifiedApril 20, 2022
✔ NPI 1003223306 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
8613 MS HIGHWAY 12, Ackerman, MS 39735
Open in Google Maps ↗

Other Names 1

Doing Business AsChoctaw Medical Clinic

Other Identifiers 1

Medicaid04477821MS

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Choctaw Medical Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

68

Medicare enrollment records show 68 clinicians reassign Medicare billing to Choctaw Medical Clinic, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 12 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 6

Nurse Practitioner29
Diagnostic Radiology23
Family Practice9
Emergency Medicine4
Interventional Radiology2
Psychiatry1

Nearest to this location (20)

See all 68
Hannah Bowman, NURSE PRACTITIONER
Nurse Practitioner
NPI 1780278739
8613 MS HIGHWAY 12
Ackerman, MS 39735
(662) 285-9460
✔ PECOS✔ Accepts MedicareSame address
Shannon Dobbs, DO
Emergency Medicine
NPI 1295099455
8613 MS HIGHWAY 12
Ackerman, MS 39735
(662) 285-4400
✔ PECOS✔ Accepts MedicareSame address
Falan Mcknight, MD
Family Practice
NPI 1073173514
8613 MS HIGHWAY 12
Ackerman, MS 39735
(662) 285-4400
✔ PECOS✔ Accepts MedicareSame address
Brittany Dickerson, FNP-C
Nurse Practitioner
NPI 1760959027
8613 MS HIGHWAY 12
Ackerman, MS 39735
(662) 285-9460
✔ PECOS✔ Accepts Medicare0.1 mi
Shunda Garner, MD
Emergency Medicine
NPI 1124017546
8613 MS HIGHWAY 12
Ackerman, MS 39735
(662) 285-4400
✔ PECOS✔ Accepts Medicare0.1 mi
Megan Hubbard, FNP-BC
Nurse Practitioner
NPI 1154981470
8613 MS HIGHWAY 12
Ackerman, MS 39735
(662) 285-9460
✔ PECOS✔ Accepts Medicare0.1 mi
Sandy Lieu, MD
Family Practice
NPI 1952716573
8613 MS HIGHWAY 12
Ackerman, MS 39735
(662) 285-4400
✔ PECOS✔ Accepts Medicare0.1 mi
Rushaunda Nash, FNP
Nurse Practitioner
NPI 1548643380
8613 MS HIGHWAY 12
Ackerman, MS 39735
(662) 285-9460
✔ PECOS✔ Accepts Medicare0.1 mi
Kelsie Vernon
Nurse Practitioner
NPI 1801789870
320 MS-15
Louisville, MS 39339
(662) 773-7500
✔ PECOS✔ Accepts Medicare0.9 mi
Harmon Prosser, MD
Family Practice
NPI 1073578886
64 N LOUISVILLE ST
Ackerman, MS 39735
(662) 285-9050
✔ PECOS✔ Accepts Medicare1.1 mi
Weston Eldridge
Family Practice
NPI 1134703366
14724 HIGHWAY 15 N
Louisville, MS 39339
(662) 773-7500
✔ PECOS✔ Accepts Medicare5.8 mi
Beverly Randle, F.N.P.
Nurse Practitioner
NPI 1184675134
14724 HIGHWAY 15 N
Louisville, MS 39339
(662) 773-7500
✔ PECOS✔ Accepts Medicare5.8 mi
Barbara Ezell
Nurse Practitioner
NPI 1649058207
14724 HIGHWAY 15 N
Louisville, MS 39339
(662) 773-7500
✔ PECOS✔ Accepts Medicare13 mi
Yoshie Lilley, FNP-C
Nurse Practitioner
NPI 1528475217
8900 MS HIGHWAY 15
Ackerman, MS 39735
(662) 387-7167
✔ PECOS✔ Accepts Medicare13 mi
Pamela Metts, FNP
Nurse Practitioner
NPI 1851781611
14724 HIGHWAY 15 N
Louisville, MS 39339
(662) 773-7500
✔ PECOS✔ Accepts Medicare13 mi
James Peters, MD
Family Practice
NPI 1114912680
14724 HIGHWAY 15 N
Louisville, MS 39339
(662) 773-7500
✔ PECOS13 mi
Valerie Sullivan, F.N.P.
Nurse Practitioner
NPI 1598716573
14724 HIGHWAY 15 N
Louisville, MS 39339
(662) 773-7500
✔ PECOS✔ Accepts Medicare13 mi
Samuel Suttle, M.D.
Family Practice
NPI 1497705453
14724 HIGHWAY 15 N
Louisville, MS 39339
(662) 773-7500
✔ PECOS✔ Accepts Medicare13 mi
Brianna Lundy, FNP
Nurse Practitioner
NPI 1972085850
455 N COURT AVE
Louisville, MS 39339
(769) 230-9423
✔ PECOS15 mi
Mitchell Moffett, D.O.
Family Practice
NPI 1881115707
49 TURNER ST
Maben, MS 39750
(662) 397-7647
✔ PECOS✔ Accepts Medicare18 mi
See all 68 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 25D2052354

Choctaw Medical Clinic · Ackerman, MS
Active · expires Nov 5, 2026
CLIA Number25D2052354
Laboratory TypeRural Health Clinic
Certificate Effective DateNovember 6, 2024
Certificate Expiration DateNovember 5, 2026
Laboratory DirectorSandy Lieu
Laboratory Phone(662) 285-9460
Laboratory LocationChoctaw Medical Clinic8613 Ms Hwy 12, Ackerman, MS 39735
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Compliance 25D2013331

Choctaw Regional Medical Center · Ackerman, MS
Active · expires May 25, 2027
CLIA Number25D2013331
Laboratory TypeHospital
Certificate Effective DateMay 26, 2025
Certificate Expiration DateMay 25, 2027
Laboratory DirectorDr. Melissa J. Brents
Laboratory Phone(662) 285-4425
Laboratory LocationChoctaw Regional Medical Center8613 Ms Hwy 12, Ackerman, MS 39735
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 25D2017094

Choctaw Medical Clinic Of Ackerman · Ackerman, MS
Active · expires Dec 2, 2026
CLIA Number25D2017094
Laboratory TypeRural Health Clinic
Certificate Effective DateDecember 3, 2024
Certificate Expiration DateDecember 2, 2026
Laboratory DirectorH Sidney Prosser
Laboratory Phone(662) 285-9050
Laboratory LocationChoctaw Medical Clinic Of Ackerman64 North Louisville Street, Ackerman, MS 39735
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Choctaw Nursing And Rehabilitation Center (CMS certification number 255347), from CMS Care Compare.

Choctaw Nursing And Rehabilitation Center

Nursing home · Ackerman, MS
1/5 CMS Overall Rating
OwnershipGovernment - County
CMS Certification Number255347
Certified Beds60 beds51 residents per day on average
Medicare & Medicaid Participant SinceOctober 19, 2018
Resident & Family CouncilResident council
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
1/5
Long-Stay Quality
Quality of care delivered to long-term residents.
1/5
Staffing
Based on nursing staff hours relative to resident needs.
1/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
28.67
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 1.82 · LPN 1.1 · RN 0.38
3.31 hrs per resident per day
Weekend Nurse Staffing
2.56 hrs per resident per day
Physical Therapist Staffing
0.05 hrs per resident per day
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
0
Substantiated Complaints
1
Infection-Control Citations
0
Fines
1 totaling $4,194.45
Medicare Payment Denials
0
Total Penalties
1
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Choctaw Regional Medical Center's NPI number?

The NPI number for Choctaw Regional Medical Center is 1003223306. It was assigned to this organization in the NPPES registry on July 18, 2014. The provider is doing business as Choctaw Medical Clinic.

Where is Choctaw Regional Medical Center located?

Choctaw Regional Medical Center is located at 8613 Ms Highway 12, Ackerman, MS 39735. The listed phone number is (662) 285-4400.

What is Choctaw Regional Medical Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Is Choctaw Regional Medical Center enrolled in Medicare?

Yes. Choctaw Regional Medical Center is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Choctaw Regional Medical Center?

According to the CMS Revalidation Reassignment List (October 2026 release), 68 clinicians in 6 Medicare specialties reassign their Medicare billing to Choctaw Regional Medical Center. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (29), Diagnostic Radiology (23) and Family Practice (9). Of these, 3 practice at this address and 12 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Choctaw Regional Medical Center hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

Is Choctaw Regional Medical Center a Medicare-certified nursing home?

Yes. Choctaw Nursing And Rehabilitation Center is a Medicare-certified nursing home with 60 certified beds.

What quality rating does Choctaw Regional Medical Center have?

CMS rates Choctaw Nursing And Rehabilitation Center 1 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does Choctaw Regional Medical Center accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 1 other insurer list Choctaw Regional Medical Center as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Choctaw Regional Medical Center was last updated on May 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.