FAMILY HEALTH CLINIC OF GRENADA
NPI 1144400607
Nurse Practitioner - Family in Grenada, MS

Active since November 13, 2007CLIA 25D1029760 · Waiver
1117 SUNSET DR STE 104, GRENADA, MS 38901(662) 226-0110(662) 226-3700 Get Directions Write a Review

NPPES record last updated: December 1, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Family Health Clinic Of Grenada NPPES

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

FAMILY HEALTH CLINIC OF GRENADA (NPI 1144400607) is a healthcare organization registered as a family in Grenada, Mississippi and active in the NPI registry since November 2007. The organization holds a CLIA Waiver certificate valid through August 22, 2026 and lists Henry Brister, Owner, as its authorized official.

NPPES Registry Identity

NPI1144400607
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameFAMILY HEALTH CLINIC OF GRENADA
Location Address1117 SUNSET DR STE 104Grenada, MS 38901-4080
Mailing Address1117 Sunset Dr Ste 104Grenada, MS 38901-4080 · (662) 226-0110 · Fax (662) 226-3700
Fax(662) 226-3700
Organization SubpartNo
Authorized OfficialHenry BristerOwner · (662) 226-0110
Enumeration DateNovember 13, 2007
Last NPPES UpdateDecember 1, 2016
NPI 1144400607 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses Licensed in MS · R875035 Licensed in MS · R742805
1117 SUNSET DR STE 104, Grenada, MS 38901

Other Identifiers 2

Medicare OSCAR/certificationC03154MS
Medicaid01476010MS

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted 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 25D1029760

Family Health Clinic Of Grenada · Grenada, MS
Active · expires Aug 22, 2026
CLIA Number25D1029760
Laboratory TypePractitioner Other
Certificate Effective DateAugust 23, 2024
Certificate Expiration DateAugust 22, 2026
Laboratory DirectorJoseph Roberts MD
Laboratory Phone(662) 226-0110
Laboratory LocationFamily Health Clinic Of Grenada1117 Sunset Drive Suite 104, Grenada, MS 38901
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 3

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

Nurse Practitioner (Family)
1117 SUNSET DR STE 104
GRENADA, MS 38901
Nurse Practitioner (Psychiatric/Mental Health)
1117 SUNSET DR STE 104
GRENADA, MS 38901
Nurse Practitioner (Family)
1117 SUNSET DR STE 104
GRENADA, MS 38901

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 Family Health Clinic Of Grenada's NPI number?

The NPI number for Family Health Clinic Of Grenada is 1144400607. It was assigned to this organization in the NPPES registry on November 13, 2007.

Where is Family Health Clinic Of Grenada located?

Family Health Clinic Of Grenada is located at 1117 Sunset Dr Ste 104, Grenada, MS 38901. The listed phone number is (662) 226-0110.

What is Family Health Clinic Of Grenada's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Family Health Clinic Of Grenada hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D1029760) is associated with this NPI, valid through August 22, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Family Health Clinic Of Grenada 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 Family Health Clinic Of Grenada 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 Family Health Clinic Of Grenada was last updated on December 1, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.