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STATCARE PLLC
NPI 1174579338
Clinic/Center in Mccomb, MS

Active since May 26, 2006CLIA Certified · 2 labs
1017 DELAWARE AVE, MCCOMB, MS 39648(601) 250-1122(601) 250-0290 Get Directions Write a Review

NPPES record last updated: October 23, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Statcare Pllc NPPES

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

STATCARE PLLC (NPI 1174579338) is a healthcare organization registered as a clinic/center in Mccomb, Mississippi and active in the NPI registry since May 2006. The organization holds 2 active CLIA laboratory certificates and lists Debra B Kennedy, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1174579338
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameSTATCARE PLLC
Location Address1017 DELAWARE AVEMccomb, MS 39648-3827
Mailing AddressPo Box 1909Mccomb, MS 39649-1909 · (601) 250-1122 · Fax (601) 250-0290
Phone(601) 250-1122
Fax(601) 250-0290
Organization SubpartNo
Authorized OfficialDebra B KennedyOffice Manager · (601) 250-1122
Enumeration DateMay 26, 2006
Last NPPES UpdateOctober 23, 2007
✔ NPI 1174579338 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
1017 DELAWARE AVE, Mccomb, MS 39648
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Other Identifiers 2

OtherCN2774MS · Medicare Railroad
Medicare ID-Type UnspecifiedC02326MS

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 2

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 25D1013463

Statcare PLLC · Mccomb, MS
Active · expires Apr 5, 2028
CLIA Number25D1013463
Laboratory TypePhysician Office
Certificate Effective DateApril 6, 2026
Certificate Expiration DateApril 5, 2028
Laboratory DirectorJohn A. Watson
Laboratory Phone(601) 250-1122
Laboratory LocationStatcare PLLC1017 Delaware Avenue, Mccomb, MS 39648
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 25D2142182

Statcare Dba Plus One Medical Clinic · Mccomb, MS
Active · expires Jan 3, 2028
CLIA Number25D2142182
Laboratory TypePhysician Office
Certificate Effective DateJanuary 4, 2026
Certificate Expiration DateJanuary 3, 2028
Laboratory DirectorJohn A. Watson
Laboratory Phone(601) 465-0745
Laboratory LocationStatcare Dba Plus One Medical Clinic208 West Presley Blvd, Ste A, Mccomb, MS 39648
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 6

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

JACKIE EUGENE BRISTER F.N.P.
Nurse Practitioner (Family)
1017 DELAWARE AVE
MCCOMB, MS 39648
Pike County (601) 250-1122
CHRISTOPHER HARVEY BRACEY FNP
Family Medicine
1017 DELAWARE AVE
MCCOMB, MS 39648
Pike County (601) 250-1122
DR. SCOTT FARR SMITH M.D.
Emergency Medicine
1017 DELAWARE AVE
MCCOMB, MS 39648
Pike County (601) 250-1122
DR. BRETT BIENVILLE TISDALE M.D.
Emergency Medicine
1017 DELAWARE AVE
MCCOMB, MS 39648
Pike County (601) 250-1122
MR. DARRYL TEMPLE FNP
Emergency Medicine
1017 DELAWARE AVE
MCCOMB, MS 39648
Pike County (601) 250-1122
DR. JOHN ANDREW WATSON D.O.
Emergency Medicine
1017 DELAWARE AVE
MCCOMB, MS 39648
Pike County (601) 250-1122

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 Statcare PLLC's NPI number?

The NPI number for Statcare PLLC is 1174579338. It was assigned to this organization in the NPPES registry on May 26, 2006.

Where is Statcare PLLC located?

Statcare PLLC is located at 1017 Delaware Ave, Mccomb, MS 39648. The listed phone number is (601) 250-1122.

What is Statcare PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Statcare PLLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Statcare PLLC 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 Statcare PLLC 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 Statcare PLLC was last updated on October 23, 2007. 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.