THAXTON FAMILY MEDICAL CLINIC LLC
NPI 1124505912
Nurse Practitioner - Primary Care in Thaxton, MS
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 lists Kevin Floyd, Provider/managing Member, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Thaxton Family Medical Clinic Llc 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 Thaxton Family Medical Clinic LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 25D2119774
Thaxton Family Medical, LLC · Thaxton, 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 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.
Is Thaxton Family Medical Clinic LLC enrolled in Medicare?
Yes. Thaxton Family Medical Clinic LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Thaxton Family Medical Clinic LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Thaxton Family Medical Clinic 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 Thaxton Family Medical Clinic LLC was last updated on July 24, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Thaxton Family Medical Clinic Llc · NPI 1124505912
Primary Care organization in Thaxton, Mississippi. Organization record, active in the CMS NPPES registry since July 24, 2018.
## Identity
- **NPI:** 1124505912 (Entity type: Organization)
- **Enumerated:** July 24, 2018
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **Organization subpart:** No
- **Authorized official:** Kevin Floyd, PROVIDER/MANAGING MEMBER
## Practice location
- **Address:** 11145 HIGHWAY 6 W, Thaxton, MS 38871-9024
- **Phone:** (662) 489-8500 · **Fax:** (662) 489-8600
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 24, 2018
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1124505912) · Data from the CMS NPPES public registry.