FAMILY MEDICAL CLINIC OF NORTH MS INC
NPI 1134174154
Family Medicine in Southaven, MS
About Family Medical Clinic Of North Ms Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FAMILY MEDICAL CLINIC OF NORTH MS INC (NPI 1134174154) is a healthcare organization registered as a family medicine in Southaven, Mississippi and active in the NPI registry since May 2006. The organization holds a CLIA Certificate of Compliance certificate valid through August 20, 2027 and lists Robert L Skinner, Vice President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Group Practice 1
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)
Family Medical Clinic Of North Ms Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 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
13Medicare enrollment records show 13 clinicians reassign Medicare billing to Family Medical Clinic Of North Ms Inc, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 11 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 3
Clinicians, nearest first (13)
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 Compliance 25D1006389
Family Medical Clinic Of North Ms · Southaven, 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 Family Medical Clinic Of North Ms Inc's NPI number?
The NPI number for Family Medical Clinic Of North Ms Inc is 1134174154. It was assigned to this organization in the NPPES registry on May 24, 2006.
Where is Family Medical Clinic Of North Ms Inc located?
Family Medical Clinic Of North Ms Inc is located at 3451 Goodman Rd Ste 115, Southaven, MS 38672. The listed phone number is (662) 890-5555.
What is Family Medical Clinic Of North Ms Inc's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Family Medical Clinic Of North Ms Inc enrolled in Medicare?
Yes. Family Medical Clinic Of North Ms Inc is registered in the Medicare PECOS enrollment system.
When is Family Medical Clinic Of North Ms Inc'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 (Mississippi, Clinic/Group Practice) is due for revalidation by March 31, 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 Family Medical Clinic Of North Ms Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 13 clinicians in 3 Medicare specialties reassign their Medicare billing to Family Medical Clinic Of North Ms Inc. 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 (8), Internal Medicine (3) and Family Practice (2). Of these, 2 practice at this address and 11 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Family Medical Clinic Of North Ms Inc hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 25D1006389) is associated with this NPI, valid through August 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Family Medical Clinic Of North Ms Inc was last updated on February 6, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Family Medical Clinic Of North Ms Inc · NPI 1134174154
Family Medicine organization in Southaven, Mississippi. Organization record, active in the CMS NPPES registry since May 24, 2006.
## Identity
- **NPI:** 1134174154 (Entity type: Organization)
- **Enumerated:** May 24, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Robert Skinner, VICE PRESIDENT
## Practice location
- **Address:** 3451 GOODMAN RD, STE 115, Southaven, MS 38672-9304
- **Phone:** (662) 890-5555 · **Fax:** (662) 890-8899
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Mississippi, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 13 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (8), Internal Medicine (3), Family Practice (2); 2 practice at this address and 11 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 6, 2008
- **Other identifiers:** Medicare PIN C02738 (MS); Other CK6296 (MS); Other CK6296 (MS)
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1134174154) · Data from the CMS NPPES public registry.