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PURVIS FAMILY PRACTICE CLINIC
NPI 1265532584
Family Medicine in Purvis, MS

Active since September 25, 2006CLIA 25D0319289 · Certificate of Compliance
102 SHELBY SPEIGHTS DR, PURVIS, MS 39475(601) 794-8065(601) 794-5650 Get Directions Write a Review

NPPES record last updated: February 18, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Purvis Family Practice Clinic NPPES

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

PURVIS FAMILY PRACTICE CLINIC (NPI 1265532584) is a healthcare organization registered as a family medicine in Purvis, Mississippi and active in the NPI registry since September 2006. The organization holds a CLIA Certificate of Compliance certificate valid through September 29, 2027 and lists Bryan N Batson, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1265532584
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameHATTIESBURG CLINIC PA
Location Address102 SHELBY SPEIGHTS DRPurvis, MS 39475-4151
Mailing Address415 S 28th AveHattiesburg, MS 39401-7246 · (601) 579-5463 · Fax (601) 579-5240
Phone(601) 794-8065
Fax(601) 794-5650
Organization SubpartNo
Authorized OfficialBryan N BatsonExecutive Director · (601) 264-6000
Enumeration DateSeptember 25, 2006
Last NPPES UpdateFebruary 18, 2021
NPPES CertifiedFebruary 12, 2021
✔ NPI 1265532584 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.
102 SHELBY SPEIGHTS DR, Purvis, MS 39475
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Other Names 1

Doing Business AsPurvis Family Practice Clinic

Other Identifiers 2

Medicaid1527661LA
Medicaid09013970MS

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 25D0319289

Purvis Family Practice Clinic · Purvis, MS
Active · expires Sep 29, 2027
CLIA Number25D0319289
Laboratory TypePhysician Office
Certificate Effective DateSeptember 30, 2025
Certificate Expiration DateSeptember 29, 2027
Laboratory DirectorDr. Angel Johnson
Laboratory Phone(601) 794-8065
Laboratory LocationPurvis Family Practice Clinic102 Shelby Speights Drive, Purvis, MS 39475
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.

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.

ANUTIDA CHAROENTONG
Internal Medicine
102 SHELBY SPEIGHTS DR
PURVIS, MS 39475
Lamar County (601) 794-8065
JASON LEE SHIVES MD
Family Medicine
102 SHELBY SPEIGHTS DR
PURVIS, MS 39475
Lamar County (601) 794-8065
MICHAEL R O'NEAL MD
Family Medicine
102 SHELBY SPEIGHTS DR
PURVIS, MS 39475
Lamar County (601) 794-8065
JOHN T CHMELICEK MD
Family Medicine
102 SHELBY SPEIGHTS DR
PURVIS, MS 39475
Lamar County (601) 794-8065
MR. BRUCE GRISSOM JR.
Family Medicine
102 SHELBY SPEIGHTS DR
PURVIS, MS 39475
Lamar County (601) 794-8065
SARAH M TUCKER FNP
Nurse Practitioner (Family)
102 SHELBY SPEIGHTS DR
PURVIS, MS 39475
Lamar County (601) 794-8068

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 1265532584. It was assigned to this organization in the NPPES registry on September 25, 2006. The provider is doing business as Purvis Family Practice Clinic.

Where is Hattiesburg Clinic PA located?

Hattiesburg Clinic PA is located at 102 Shelby Speights Dr, Purvis, MS 39475. The listed phone number is (601) 794-8065.

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 25D0319289) is associated with this NPI, valid through September 29, 2027. 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 February 18, 2021. 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.