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PRENTISS FAMILY PRACTICE CLINIC
NPI 1215023122
Family Medicine in Prentiss, MS

Active since October 05, 2006CLIA 25D0662440 · Certificate of Compliance
1014 ROSE STREET, PRENTISS, MS 39474(601) 792-2071(601) 792-8134 Get Directions Write a Review

NPPES record last updated: October 7, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 7, 2020, Oct 2, 2015 (2 updates tracked since 2015).

About Prentiss Family Practice Clinic NPPES

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

PRENTISS FAMILY PRACTICE CLINIC (NPI 1215023122) is a healthcare organization registered as a family medicine in Prentiss, Mississippi and active in the NPI registry since October 2006. The organization holds a CLIA Certificate of Compliance certificate valid through October 8, 2026 and lists Bryan N Batson, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1215023122
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameHATTIESBURG CLINIC PA
Location Address1014 ROSE STREETPrentiss, MS 39474
Mailing Address415 S 28th AveHattiesburg, MS 39401-7246 · (601) 579-5463 · Fax (601) 579-5240
Phone(601) 792-2071
Fax(601) 792-8134
Organization SubpartNo
Authorized OfficialBryan N BatsonExecutive Director · (601) 268-5601
Enumeration DateOctober 5, 2006
Last NPPES UpdateOctober 7, 20202 updates tracked since enumeration
NPPES CertifiedOctober 7, 2020
✔ NPI 1215023122 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1014 ROSE STREET, Prentiss, MS 39474
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Other Names 1

Doing Business AsPrentiss Family Practice Clinic

Other Identifiers 1

Medicaid09014320MS

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

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 25D0662440

Prentiss Family Practice Clinic · Prentiss, MS
Active · expires Oct 8, 2026
CLIA Number25D0662440
Laboratory TypePhysician Office
Certificate Effective DateOctober 9, 2024
Certificate Expiration DateOctober 8, 2026
Laboratory DirectorDr. Lori Galloway
Laboratory Phone(601) 792-2071
Laboratory LocationPrentiss Family Practice Clinic1014 Rose Street, Prentiss, MS 39474
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.

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 Hattiesburg Clinic PA's NPI number?

The NPI number for Hattiesburg Clinic PA is 1215023122. It was assigned to this organization in the NPPES registry on October 5, 2006. The provider is doing business as Prentiss Family Practice Clinic.

Where is Hattiesburg Clinic PA located?

Hattiesburg Clinic PA is located at 1014 Rose Street, Prentiss, MS 39474. The listed phone number is (601) 792-2071.

What is Hattiesburg Clinic PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Hattiesburg Clinic PA hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 25D0662440) is associated with this NPI, valid through October 8, 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 Hattiesburg Clinic PA was last updated on October 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.