MONTICELLO FAMILY MEDICINE
NPI 1275073512
Family Medicine in Monticello, MS

Q: What is Hattiesburg Clinic, PA's NPI number?

The NPI number for Hattiesburg Clinic, PA is 1275073512. It was assigned to this organization in the NPPES registry on March 6, 2017. The provider is also known as Monticello Family Medicine.

Q: What is Hattiesburg Clinic, PA's specialty?

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

Active since March 06, 2017CLIA 25D1087483 · Waiver

128 COURTHOUSE SQ, MONTICELLO, MS 39654(601) 587-0209(601) 587-0436 Get Directions Write a Review

NPPES record last updated: February 18, 2021. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Monticello Family Medicine NPPES

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

MONTICELLO FAMILY MEDICINE (NPI 1275073512) is a healthcare organization registered as a family medicine in Monticello, Mississippi and active in the NPI registry since March 2017. The organization holds a CLIA Waiver certificate valid through February 28, 2027 and lists Bryan N Batson, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1275073512

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameHATTIESBURG CLINIC, PA

Location Address128 COURTHOUSE SQMonticello, MS 39654-6014

Mailing Address415 S 28th AveHattiesburg, MS 39401-7246 · (601) 587-0209 · Fax (601) 579-5240

Phone(601) 587-0209

Fax(601) 587-0436

Organization SubpartNo

Authorized OfficialBryan N BatsonExecutive Director · (601) 264-6000

Enumeration DateMarch 6, 2017

Last NPPES UpdateFebruary 18, 2021

NPPES CertifiedFebruary 18, 2021

✔ NPI 1275073512 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.

128 COURTHOUSE SQ, Monticello, MS 39654

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Other Names 1

Other NameMonticello Family Medicine

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 Waiver 25D1087483

Monticello Family Medicine · Monticello, MS

Active · expires Feb 28, 2027

CLIA Number25D1087483

Laboratory TypePhysician Office

Certificate Effective DateMarch 1, 2025

Certificate Expiration DateFebruary 28, 2027

Laboratory DirectorJames Stephens

Laboratory Phone(601) 587-0209

Laboratory LocationMonticello Family Medicine128 Courthouse Square, Monticello, MS 39654

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 2

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

JAMES WYATT STEPHENS M.D.

Family Medicine

128 COURTHOUSE SQ
MONTICELLO, MS 39654

Lawrence County (601) 587-0209

JAMES W STEPHENS MD FAMILY MEDICINE PLLC

Clinic/Center (Primary Care)

128 COURTHOUSE SQ
MONTICELLO, MS 39654

Lawrence County (601) 587-0209

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 1275073512. It was assigned to this organization in the NPPES registry on March 6, 2017. The provider is also known as Monticello Family Medicine.

Where is Hattiesburg Clinic, PA located?

Hattiesburg Clinic, PA is located at 128 Courthouse Sq, Monticello, MS 39654. The listed phone number is (601) 587-0209.

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 Waiver (number 25D1087483) is associated with this NPI, valid through February 28, 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.