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LEGACY FAMILY CARE CLINIC
NPI 1003620675
Clinic/Center - Primary Care in Hattiesburg, MS

Active since February 04, 2025CLIA 25D2317852 · Waiver
6798 U S HIGHWAY 98 STE 30, HATTIESBURG, MS 39402(601) 596-9053(601) 336-6615 Get Directions Write a Review

NPPES record last updated: June 12, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 12, 2025, Feb 4, 2025 (2 updates tracked since 2025).

About Legacy Family Care Clinic NPPES

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

LEGACY FAMILY CARE CLINIC (NPI 1003620675) is a healthcare organization registered as a primary care in Hattiesburg, Mississippi and active in the NPI registry since February 2025. The organization holds a CLIA Waiver certificate valid through January 30, 2027 and lists Tarah Chatham, Owner, as its authorized official.

NPPES Registry Identity

NPI1003620675
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameLEGACY FAMILY CARE CLINIC
Location Address6798 U S HIGHWAY 98 STE 30Hattiesburg, MS 39402-7987
Mailing Address6798 U S Highway 98 Ste 30Hattiesburg, MS 39402-7987 · (601) 596-9053 · Fax (601) 336-6615
Phone(601) 596-9053
Fax(601) 336-6615
Organization SubpartNo
Authorized OfficialTarah ChathamOwner · (601) 596-9053
Enumeration DateFebruary 4, 2025
Last NPPES UpdateJune 12, 20252 updates tracked since enumeration
NPPES CertifiedMay 13, 2025
✔ NPI 1003620675 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
6798 U S HIGHWAY 98 STE 30, Hattiesburg, MS 39402
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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)

Legacy Family Care Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Legacy Family Care Clinic, which bills Medicare for the services this clinician delivers.

Clinician (1)

Tarah Chatham, FNP
Nurse Practitioner
NPI 1811355605
6798 US HIGHWAY 98 SUITE 30
Hattiesburg, MS 39402
(601) 596-9053
✔ PECOS✔ Accepts MedicareSame address

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

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 of Waiver 25D2317852

Legacy Family Care Clinic LLC · Hattiesburg, MS
Active · expires Jan 30, 2027
CLIA Number25D2317852
Laboratory TypePhysician Office
Certificate Effective DateJanuary 31, 2025
Certificate Expiration DateJanuary 30, 2027
Laboratory DirectorTarah Chatham
Laboratory Phone(601) 596-9053
Laboratory LocationLegacy Family Care Clinic LLC6798 Us Hwy 98 W Suite 30, Hattiesburg, MS 39402
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Legacy Family Care Clinic's NPI number?

The NPI number for Legacy Family Care Clinic is 1003620675. It was assigned to this organization in the NPPES registry on February 4, 2025.

Where is Legacy Family Care Clinic located?

Legacy Family Care Clinic is located at 6798 U S Highway 98 Ste 30, Hattiesburg, MS 39402. The listed phone number is (601) 596-9053.

What is Legacy Family Care Clinic's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Legacy Family Care Clinic enrolled in Medicare?

Yes. Legacy Family Care Clinic is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Legacy Family Care Clinic?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Legacy Family Care Clinic. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Legacy Family Care Clinic hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2317852) is associated with this NPI, valid through January 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Legacy Family Care Clinic 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 Legacy Family Care Clinic 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 Legacy Family Care Clinic was last updated on June 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.