NEWSOM HEALTHCARE OF DESOTO COUNTY, LLC
NPI 1205243649
Clinic/Center - Primary Care in Horn Lake, MS
About Newsom Healthcare Of Desoto County, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NEWSOM HEALTHCARE OF DESOTO COUNTY, LLC (NPI 1205243649) is a healthcare organization registered as a primary care in Horn Lake, Mississippi and active in the NPI registry since July 2014. The organization holds a CLIA Microscopy certificate valid through September 16, 2028 and lists Sandra Matthews Newsom, Owner/president, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Newsom Healthcare Of Desoto County, 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 Newsom Healthcare Of Desoto County, 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 for Provider-Performed Microscopy Procedures (PPMP) 25D1089399
Newsom Healthcare Of Desoto County, LLC · Horn Lake, 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 Newsom Healthcare Of Desoto County, LLC's NPI number?
The NPI number for Newsom Healthcare Of Desoto County, LLC is 1205243649. It was assigned to this organization in the NPPES registry on July 17, 2014.
Where is Newsom Healthcare Of Desoto County, LLC located?
Newsom Healthcare Of Desoto County, LLC is located at 2906 Goodman Rd W Suite 109, Horn Lake, MS 38637. The listed phone number is (662) 393-8022.
What is Newsom Healthcare Of Desoto County, LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Newsom Healthcare Of Desoto County, LLC enrolled in Medicare?
Yes. Newsom Healthcare Of Desoto County, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Newsom Healthcare Of Desoto County, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Newsom Healthcare Of Desoto County, 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.
Does Newsom Healthcare Of Desoto County, LLC hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 25D1089399) is associated with this NPI, valid through September 16, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Newsom Healthcare Of Desoto County, LLC was last updated on July 22, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Newsom Healthcare Of Desoto County, Llc · NPI 1205243649
Primary Care organization in Horn Lake, Mississippi. Organization record, active in the CMS NPPES registry since July 17, 2014.
## Identity
- **NPI:** 1205243649 (Entity type: Organization)
- **Enumerated:** July 17, 2014
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Sandra Newsom, OWNER/PRESIDENT
## Practice location
- **Address:** 2906 GOODMAN RD W, SUITE 109, Horn Lake, MS 38637-1291
- **Phone:** (662) 393-8022 · **Fax:** (662) 393-8052
## 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 22, 2014
- **Other identifiers:** Medicare PIN 500000473 (MS); Medicare UPIN S78544 (MS); Medicaid 00117535 (MS)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1205243649) · Data from the CMS NPPES public registry.