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

Q: 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.

Q: 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.

Q: 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.

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: August 09, 2026.

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

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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 from Magnolia Health and more.Insurance ›

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

Substantiated Complaints

Infection-Control Citations

Fines

1 totaling $4,194.45

Medicare Payment Denials

Total Penalties

Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. KELLIE RONE CAUTHEN RN, MSN, NP-C

Nurse Practitioner (Family)