1. Home
  2. Directory
  3. Mississippi
  4. Ridgeland
  5. Preferred Provider Organization
  6. NPI Profile

MADISON-RIDGELAND MEDICAL CLINIC
NPI 1285894378
Preferred Provider Organization in Ridgeland, MS

Active since June 11, 2008CLIA 25D0856603 · Microscopy
12 PROFESSIONAL PKWY, RIDGELAND, MS 39157(601) 856-2460(601) 856-4687 Get Directions Write a Review

NPPES record last updated: June 11, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Madison-ridgeland Medical Clinic NPPES

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

MADISON-RIDGELAND MEDICAL CLINIC (NPI 1285894378) is a healthcare organization registered as a preferred provider organization in Ridgeland, Mississippi and active in the NPI registry since June 2008. The organization holds a CLIA Microscopy certificate valid through August 31, 2026 and lists Wesley Dee Granger, Owner, as its authorized official.

NPPES Registry Identity

NPI1285894378
Entity TypeOrganization
Primary Taxonomy305R00000X
Legal Business NameWESLEY DEE GRANGER, M.D., P.A.
Location Address12 PROFESSIONAL PKWYRidgeland, MS 39157-4113
Mailing Address12 Professional PkwyRidgeland, MS 39157-4113 · (601) 856-2460 · Fax (601) 856-4687
Phone(601) 856-2460
Fax(601) 856-4687
Organization SubpartNo
Authorized OfficialWesley Dee GrangerOwner · (601) 856-2460
Enumeration DateJune 11, 2008
✔ NPI 1285894378 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPreferred Provider OrganizationManaged Care Organizations
Taxonomy Code305R00000X
License✔ Licensed in MS · 11037
Definition
A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.
Also ListedPoint of ServiceTaxonomy 305S00000X · License 11037 (MS)
12 PROFESSIONAL PKWY, Ridgeland, MS 39157
Open in Google Maps ↗

Other Names 1

Other NameMadison-ridgeland Medical Clinic

Other Identifiers 3

Medicaid00017026MS
Medicare UPIND088022MS
Medicare PIN110000443MS

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 for Provider-Performed Microscopy Procedures (PPMP) 25D0856603

Madison Ridgeland Medical Clinic · Ridgeland, MS
Active · expires Aug 31, 2026
CLIA Number25D0856603
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorIndira Veerisetty
Laboratory Phone(601) 856-2460
Laboratory LocationMadison Ridgeland Medical Clinic11 Professional Parkway, Ridgeland, MS 39157
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform 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.

INDIRA INC
Internal Medicine
12 PROFESSIONAL PKWY
RIDGELAND, MS 39157
Madison County (601) 856-2460
MR. LARRY KEITH SALTER JR. OT
Occupational Therapist
12 PROFESSIONAL PKWY
RIDGELAND, MS 39157
Madison County (601) 672-3611

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 Wesley Dee Granger, M.D., P.A.'s NPI number?

The NPI number for Wesley Dee Granger, M.D., P.A. is 1285894378. It was assigned to this organization in the NPPES registry on June 11, 2008. The provider is also known as Madison-Ridgeland Medical Clinic.

Where is Wesley Dee Granger, M.D., P.A. located?

Wesley Dee Granger, M.D., P.A. is located at 12 Professional Pkwy, Ridgeland, MS 39157. The listed phone number is (601) 856-2460.

What is Wesley Dee Granger, M.D., P.A.'s specialty?

The primary specialty registered for this NPI is Preferred Provider Organization with taxonomy code 305R00000X.

Does Wesley Dee Granger, M.D., P.A. hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 25D0856603) is associated with this NPI, valid through August 31, 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 Wesley Dee Granger, M.D., P.A. was last updated on June 11, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.