RIDGELAND MEDICAL CLINIC
NPI 1053917849
Family Medicine in Ridgeland, MS
About Ridgeland Medical Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RIDGELAND MEDICAL CLINIC (NPI 1053917849) is a healthcare organization registered as a family medicine in Ridgeland, Mississippi and active in the NPI registry since December 2020. The organization holds a CLIA Waiver certificate valid through November 30, 2026, maintains a secondary practice location in Gluckstadt, and lists Erica Berry, Admin, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ridgeland Medical Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
15Medicare enrollment records show 15 clinicians reassign Medicare billing to Ridgeland Medical Clinic, which bills Medicare for the services they deliver. Of these, 7 practice within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 3
Clinicians, nearest first (15)
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 25D2202829
Ridgeland Medical Clinic · Ridgeland, MSFrequently 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 Ridgeland Medical Clinic's NPI number?
The NPI number for Ridgeland Medical Clinic is 1053917849. It was assigned to this organization in the NPPES registry on December 8, 2020.
Where is Ridgeland Medical Clinic located?
Ridgeland Medical Clinic is located at 587 Highway 51 Ste T, Ridgeland, MS 39157. The listed phone number is (601) 790-7711.
What is Ridgeland Medical Clinic's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Ridgeland Medical Clinic enrolled in Medicare?
Yes. Ridgeland Medical Clinic is registered in the Medicare PECOS enrollment system.
When is Ridgeland Medical Clinic's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Georgia, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Ridgeland Medical Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 15 clinicians in 3 Medicare specialties reassign their Medicare billing to Ridgeland Medical 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. The largest specialties are Nurse Practitioner (12), Family Practice (2) and Internal Medicine (1). Of these, 7 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Ridgeland Medical Clinic hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 25D2202829) is associated with this NPI, valid through November 30, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Ridgeland Medical 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 Ridgeland Medical 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 Ridgeland Medical Clinic was last updated on April 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Ridgeland Medical Clinic · NPI 1053917849
Family Medicine organization in Ridgeland, Mississippi. Organization record, active in the CMS NPPES registry since December 8, 2020.
## Identity
- **NPI:** 1053917849 (Entity type: Organization)
- **Enumerated:** December 8, 2020
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Erica Berry, ADMIN
## Practice location
- **Address:** 587 HIGHWAY 51 STE T, Ridgeland, MS 39157-2567
- **Phone:** (601) 790-7711 · **Fax:** (601) 790-7712
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, Georgia, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 15 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (12), Family Practice (2), Internal Medicine (1); 7 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 23, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1053917849) · Data from the CMS NPPES public registry.