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OAK GROVE FAMILY CLINIC
NPI 1265872782
Family Medicine in Hattiesburg, MS

Active since June 28, 2013CLIA 25D0704296 · Certificate of Compliance
5192 OLD HIGHWAY 11, SUITE 2, HATTIESBURG, MS 39402(601) 268-0929(601) 261-0508 Get Directions Write a Review

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

About Oak Grove Family Clinic NPPES

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

OAK GROVE FAMILY CLINIC (NPI 1265872782) is a healthcare organization registered as a family medicine in Hattiesburg, Mississippi and active in the NPI registry since June 2013. The organization holds a CLIA Certificate of Compliance certificate valid through October 25, 2027 and lists Bryan N Batson, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1265872782
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameHATTIESBURG CLINIC PA
Location Address5192 OLD HIGHWAY 11, SUITE 2Hattiesburg, MS 39402-6222
Mailing Address415 S 28th AveHattiesburg, MS 39401-7246 · (601) 268-0929 · Fax (601) 261-0508
Phone(601) 268-0929
Fax(601) 261-0508
Organization SubpartNo
Authorized OfficialBryan N BatsonExecutive Director · (601) 264-6000
Enumeration DateJune 28, 2013
Last NPPES UpdateFebruary 18, 2021
NPPES CertifiedFebruary 18, 2021
✔ NPI 1265872782 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.
5192 OLD HIGHWAY 11, Hattiesburg, MS 39402
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Other Names 1

Doing Business AsOak Grove Family Clinic

Other Identifiers 1

Medicaid04888240MS

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 25D0704296

Hattiesburg Clinic, PA Dba Oak Grove Family Clinic · Hattiesburg, MS
Active · expires Oct 25, 2027
CLIA Number25D0704296
Laboratory TypePhysician Office
Certificate Effective DateOctober 26, 2025
Certificate Expiration DateOctober 25, 2027
Laboratory DirectorJ D. Dumas III
Laboratory Phone(601) 268-0929
Laboratory LocationHattiesburg Clinic, PA Dba Oak Grove Family Clinic5192 Old Hwy 11, Hattiesburg, MS 39402
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 4

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

OAK GROVE FAMILY CLINIC
Clinic/Center (Primary Care)
5192 OLD HIGHWAY 11, SUITE 2
HATTIESBURG, MS 39402
Lamar County (601) 268-0929
MR. J D DUMAS MD
Family Medicine
5192 OLD HIGHWAY 11, SUITE 2
HATTIESBURG, MS 39402
Lamar County (601) 268-0929
MRS. ALEZA MARIE BOYETTE NP
Nurse Practitioner (Family)
5192 OLD HIGHWAY 11
HATTIESBURG, MS 39402
Lamar County (601) 268-0929
LISA BOYER GATWOOD FNP
Nurse Practitioner (Family)
5192 OLD HIGHWAY 11
HATTIESBURG, MS 39402
Lamar County (601) 268-0929

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 1265872782. It was assigned to this organization in the NPPES registry on June 28, 2013. The provider is doing business as Oak Grove Family Clinic.

Where is Hattiesburg Clinic PA located?

Hattiesburg Clinic PA is located at 5192 Old Highway 11 Suite 2, Hattiesburg, MS 39402. The listed phone number is (601) 268-0929.

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 25D0704296) is associated with this NPI, valid through October 25, 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.