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NORTH LAUREL FAMILY MEDICINE, LLC
NPI 1265921985
Nurse Practitioner in Laurel, MS

Active since May 08, 2018CLIA 25D2054130 · Waiver
3115 AUDUBON DR, LAUREL, MS 39440(601) 531-2200(601) 531-2220 Get Directions Write a Review

NPPES record last updated: January 16, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 4, 2019, Jan 29, 2019, Jan 21, 2019 and 2 more (5 updates tracked since 2018).

About North Laurel Family Medicine, Llc NPPES

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

NORTH LAUREL FAMILY MEDICINE, LLC (NPI 1265921985) is a healthcare organization registered as a nurse practitioner in Laurel, Mississippi and active in the NPI registry since May 2018. The organization holds a CLIA Waiver certificate valid through October 24, 2026, maintains a secondary practice location in Sandersville, and lists Hope Jackson, Billing/credentialing, as its authorized official.

NPPES Registry Identity

NPI1265921985
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameNORTH LAUREL FAMILY MEDICINE, LLC
Location Address3115 AUDUBON DRLaurel, MS 39440
Mailing Address3115 Audubon DrLaurel, MS 39440-1913 · (601) 531-2200 · Fax (601) 531-2220
Phone(601) 531-2200
Fax(601) 531-2220
Organization SubpartNo
Authorized OfficialHope JacksonBilling/credentialing · (601) 498-4673
Enumeration DateMay 8, 2018
Last NPPES UpdateJanuary 16, 20255 updates tracked since enumeration
NPPES CertifiedJanuary 14, 2025
✔ NPI 1265921985 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
3115 AUDUBON DR, Laurel, MS 39440
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Secondary Practice Location 1

Location 1109 N Front StreetSandersville, MS 39477 · Phone (601) 490-7190 · Fax (601) 490-7191

Other Identifiers 1

Medicaid08886271MS

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

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 Waiver 25D2054130

North Laurel Family Medicine LLC · Laurel, MS
Active · expires Oct 24, 2026
CLIA Number25D2054130
Laboratory TypePractitioner Other
Certificate Effective DateOctober 25, 2024
Certificate Expiration DateOctober 24, 2026
Laboratory DirectorJeffrey Moffett
Laboratory Phone(601) 531-2200
Laboratory LocationNorth Laurel Family Medicine LLC3115 Audubon Dr, Laurel, MS 39440
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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.

UNLIMITED DREAMS II
Hospice Care, Community Based
3115 AUDUBON DR
LAUREL, MS 39440
Jones County (601) 425-4888
CHARLES STEVEN WOOD JR. NP-C
Nurse Practitioner (Family)
3115 AUDUBON DR
LAUREL, MS 39440
Jones County (601) 531-2200
AMANDA LUCILLE LANDRUM-MCCALLUM C-FNP
Nurse Practitioner (Family)
3115 AUDUBON DR
LAUREL, MS 39440
Jones County (601) 531-2200
BRITTANY LASHEA REYES FNP
Nurse Practitioner (Family)
3115 AUDUBON DR
LAUREL, MS 39440
Jones County (601) 531-2200
MRS. SHEILA DIANE BRADFORD FNP
Nurse Practitioner (Family)
3115 AUDUBON DR
LAUREL, MS 39440
Jones County (601) 531-2200
MR. JEFFREY R. MOFFETT FNP
Nurse Practitioner
3115 AUDUBON DR
LAUREL, MS 39440
Jones County (601) 531-2200

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 North Laurel Family Medicine, LLC's NPI number?

The NPI number for North Laurel Family Medicine, LLC is 1265921985. It was assigned to this organization in the NPPES registry on May 8, 2018.

Where is North Laurel Family Medicine, LLC located?

North Laurel Family Medicine, LLC is located at 3115 Audubon Dr, Laurel, MS 39440. The listed phone number is (601) 531-2200.

What is North Laurel Family Medicine, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Does North Laurel Family Medicine, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2054130) is associated with this NPI, valid through October 24, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does North Laurel Family Medicine, LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee and 1 other insurer list North Laurel Family Medicine, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for North Laurel Family Medicine, LLC was last updated on January 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.