GOUGH'S FAMILY MEDICAL CLINIC
NPI 1043665532
Nurse Practitioner - Family in Drew, MS
About Gough's Family Medical Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GOUGH'S FAMILY MEDICAL CLINIC (NPI 1043665532) is a healthcare organization registered as a family in Drew, Mississippi and active in the NPI registry since May 2016. The organization lists Nora Gough-davis, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Gough's Family Medical Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
10Medicare enrollment records show 10 clinicians reassign Medicare billing to Gough's Family Medical Clinic, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (10)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Shaw Family Medical, LLC's NPI number?
The NPI number for Shaw Family Medical, LLC is 1043665532. It was assigned to this organization in the NPPES registry on May 3, 2016. The provider is doing business as Gough's Family Medical Clinic.
Where is Shaw Family Medical, LLC located?
Shaw Family Medical, LLC is located at 189 N Main St, Drew, MS 38737. The listed phone number is (662) 745-6638.
What is Shaw Family Medical, LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Shaw Family Medical, LLC enrolled in Medicare?
Yes. Shaw Family Medical, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Shaw Family Medical, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 10 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Shaw Family Medical, LLC. 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.
When was this NPI record last updated?
The NPPES record for Shaw Family Medical, LLC was last updated on May 3, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Gough's Family Medical Clinic · NPI 1043665532
Family organization in Drew, Mississippi. Organization record, active in the CMS NPPES registry since May 3, 2016.
## Identity
- **NPI:** 1043665532 (Entity type: Organization)
- **Enumerated:** May 3, 2016
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Legal business name:** Shaw Family Medical, Llc
- **Organization subpart:** Yes (part of Shaw Family Medical, Llc)
- **Authorized official:** Nora Gough-Davis, OWNER
## Practice location
- **Address:** 189 N MAIN ST, Drew, MS 38737-3146
- **Phone:** (662) 745-6638 · **Fax:** (662) 745-8480
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 10 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 3, 2016
- **Other identifiers:** Medicaid 04406222 (MS); Medicare UPIN 3070G0428 (MS)
---
Source: [NPI Profile](https://npiprofile.com/npi/1043665532) · Data from the CMS NPPES public registry.