THAXTON FAMILY MEDICAL CLINIC LLC
NPI 1124505912
Nurse Practitioner - Primary Care in Thaxton, MS

Active since July 24, 2018CLIA 25D2119774 · Waiver
11145 HIGHWAY 6 W, THAXTON, MS 38871(662) 489-8500(662) 489-8600 Get Directions Write a Review

NPPES record last updated: July 24, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Thaxton Family Medical Clinic Llc NPPES

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

THAXTON FAMILY MEDICAL CLINIC LLC (NPI 1124505912) is a healthcare organization registered as a primary care in Thaxton, Mississippi and active in the NPI registry since July 2018. The organization holds a CLIA Waiver certificate valid through October 3, 2026 and lists Kevin Floyd, Provider/managing Member, as its authorized official.

NPPES Registry Identity

NPI1124505912
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NameTHAXTON FAMILY MEDICAL CLINIC LLC
Location Address11145 HIGHWAY 6 WThaxton, MS 38871-9024
Mailing Address11145 Highway 6 WThaxton, MS 38871-9024 · (662) 489-8500 · Fax (662) 489-8600
Fax(662) 489-8600
Organization SubpartNo
Authorized OfficialKevin FloydProvider/managing Member · (662) 213-7890
Enumeration DateJuly 24, 2018
NPI 1124505912 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License Licensed in MS · 901818
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X · License 901818 (MS)
11145 HIGHWAY 6 W, Thaxton, MS 38871

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 25D2119774

Thaxton Family Medical, LLC · Thaxton, MS
Active · expires Oct 3, 2026
CLIA Number25D2119774
Laboratory TypeCommunity Clinic
Certificate Effective DateOctober 4, 2024
Certificate Expiration DateOctober 3, 2026
Laboratory DirectorKevin A. Floyd
Laboratory Phone(662) 489-8500
Laboratory LocationThaxton Family Medical, LLC11145 Hwy 6 West, Thaxton, MS 38871
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

Nurse Practitioner (Family)
11145 HIGHWAY 6 W
THAXTON, MS 38871
Nurse Practitioner (Family)
11145 HIGHWAY 6 W
THAXTON, MS 38871
Nurse Practitioner (Family)
11145 HIGHWAY 6 W
THAXTON, MS 38871
Nurse Practitioner (Family)
11145 HIGHWAY 6 W
THAXTON, MS 38871

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 Thaxton Family Medical Clinic LLC's NPI number?

The NPI number for Thaxton Family Medical Clinic LLC is 1124505912. It was assigned to this organization in the NPPES registry on July 24, 2018.

Where is Thaxton Family Medical Clinic LLC located?

Thaxton Family Medical Clinic LLC is located at 11145 Highway 6 W, Thaxton, MS 38871. The listed phone number is (662) 489-8500.

What is Thaxton Family Medical Clinic LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Does Thaxton Family Medical Clinic LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2119774) is associated with this NPI, valid through October 3, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Thaxton Family Medical Clinic LLC was last updated on July 24, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.