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NEWSOM HEALTHCARE OF DESOTO COUNTY, LLC
NPI 1205243649
Clinic/Center - Primary Care in Horn Lake, MS

Active since July 17, 2014CLIA 25D1089399 · Microscopy
2906 GOODMAN RD W, SUITE 109, HORN LAKE, MS 38637(662) 393-8022(662) 393-8052 Get Directions Write a Review

NPPES record last updated: July 22, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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, 2026 and lists Sandra Matthews Newsom, Owner/president, as its authorized official.

NPPES Registry Identity

NPI1205243649
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameNEWSOM HEALTHCARE OF DESOTO COUNTY, LLC
Location Address2906 GOODMAN RD W, SUITE 109Horn Lake, MS 38637-1291
Mailing Address2906 Goodman Rd W, Suite 109Horn Lake, MS 38637-1291 · (662) 393-8022 · Fax (662) 393-8052
Phone(662) 393-8022
Fax(662) 393-8052
Organization SubpartNo
Authorized OfficialSandra Matthews NewsomOwner/president · (662) 393-8022
Enumeration DateJuly 17, 2014
Last NPPES UpdateJuly 22, 2014
✔ NPI 1205243649 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in MS · R852706
2906 GOODMAN RD W, Horn Lake, MS 38637
Open in Google Maps ↗

Other Identifiers 3

Medicare PIN500000473MS
Medicare UPINS78544MS
Medicaid00117535MS

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, MS
Active · expires Sep 16, 2026
CLIA Number25D1089399
Laboratory TypeCommunity Clinic
Certificate Effective DateSeptember 17, 2024
Certificate Expiration DateSeptember 16, 2026
Laboratory DirectorSandra M. Newsom
Laboratory Phone(662) 393-8022
Laboratory LocationNewsom Healthcare Of Desoto County, LLC3400 Goodman Rd W, Horn Lake, MS 38637
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 2

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

SANDRA NEWSOM FNP
Nurse Practitioner (Family)
2906 GOODMAN RD W, SUITE 109
HORN LAKE, MS 38637
Desoto County (662) 393-8022
NEWSOM HEALTHCARE, INC
Family Medicine
2906 GOODMAN RD W, SUITE 109
HORN LAKE, MS 38637
Desoto County (662) 393-8022

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 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.

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, 2026. 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.