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MILESTONES PEDIATRIC CLINIC, LLC
NPI 1114543980
Nurse Practitioner - Pediatrics in Brookhaven, MS

Active since June 17, 2020CLIA 25D2186591 · Waiver
224 S CHURCH ST STE B, BROOKHAVEN, MS 39601(601) 990-4028 Get Directions Write a Review

NPPES record last updated: January 19, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 19, 2023, Aug 13, 2020, Jun 17, 2020 (3 updates tracked since 2020).

About Milestones Pediatric Clinic, Llc NPPES

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

MILESTONES PEDIATRIC CLINIC, LLC (NPI 1114543980) is a healthcare organization registered as a pediatrics in Brookhaven, Mississippi and active in the NPI registry since June 2020. The organization holds a CLIA Waiver certificate valid through June 17, 2028 and lists Ashley Hatcher Hickman, Owner, as its authorized official.

NPPES Registry Identity

NPI1114543980
Entity TypeOrganization
Primary Taxonomy363LP0200X
Legal Business NameMILESTONES PEDIATRIC CLINIC, LLC
Location Address224 S CHURCH ST STE BBrookhaven, MS 39601-3232
Mailing Address224 S Church St Ste BBrookhaven, MS 39601-3232 · (601) 990-4028
Phone(601) 990-4028
Organization SubpartNo
Authorized OfficialAshley Hatcher HickmanOwner · (601) 990-4028
Enumeration DateJune 17, 2020
Last NPPES UpdateJanuary 19, 20233 updates tracked since enumeration
NPPES CertifiedJanuary 19, 2023
✔ NPI 1114543980 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
224 S CHURCH ST STE B, Brookhaven, MS 39601
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Other Identifiers 1

Medicaid008700082MS

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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

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 25D2186591

Milestones Pediatric Clinic LLC · Brookhaven, MS
Active · expires Jun 17, 2028
CLIA Number25D2186591
Laboratory TypePractitioner Other
Certificate Effective DateJune 18, 2026
Certificate Expiration DateJune 17, 2028
Laboratory DirectorAshley H. Hickman
Laboratory Phone(601) 757-2060
Laboratory LocationMilestones Pediatric Clinic LLC224B S Church St, Brookhaven, MS 39601
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

ASHLEY HICKMAN CPNP
Nurse Practitioner (Pediatrics)
224 S CHURCH ST STE B
BROOKHAVEN, MS 39601
Lincoln County (601) 757-2060

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 Milestones Pediatric Clinic, LLC's NPI number?

The NPI number for Milestones Pediatric Clinic, LLC is 1114543980. It was assigned to this organization in the NPPES registry on June 17, 2020.

Where is Milestones Pediatric Clinic, LLC located?

Milestones Pediatric Clinic, LLC is located at 224 S Church St Ste B, Brookhaven, MS 39601. The listed phone number is (601) 990-4028.

What is Milestones Pediatric Clinic, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Does Milestones Pediatric Clinic, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2186591) is associated with this NPI, valid through June 17, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Milestones Pediatric Clinic, LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee and 1 other insurer list Milestones Pediatric Clinic, LLC 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 Milestones Pediatric Clinic, LLC was last updated on January 19, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.