1. Home
  2. Directory
  3. Mississippi
  4. Hazlehurst
  5. Family Medicine
  6. NPI Profile

HAZLEHURST CLINIC
NPI 1356448591
Family Medicine in Hazlehurst, MS

Active since September 20, 2006CLIA 25D0317528 · Waiver
213 CALDWELL DR, HAZLEHURST, MS 39083(601) 894-2514(601) 894-2514 Get Directions Write a Review

NPPES record last updated: September 22, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Hazlehurst Clinic NPPES

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

HAZLEHURST CLINIC (NPI 1356448591) is a healthcare organization registered as a family medicine in Hazlehurst, Mississippi and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through March 3, 2028 and lists Kortney M. Gaddy, Cfo, as its authorized official.

NPPES Registry Identity

NPI1356448591
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCOPIAH COUNTY MEDICAL CENTER
Location Address213 CALDWELL DRHazlehurst, MS 39083
Mailing Address27190 Hwy 28Hazlehurst, MS 39083 · (601) 574-7200 · Fax (601) 894-2514
Phone(601) 894-2514
Fax(601) 894-2514
Organization SubpartYes
Authorized OfficialKortney M. GaddyCfo · (601) 574-7200
Enumeration DateSeptember 20, 2006
Last NPPES UpdateSeptember 22, 2022
NPPES CertifiedSeptember 22, 2022
✔ NPI 1356448591 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.
213 CALDWELL DR, Hazlehurst, MS 39083
Open in Google Maps ↗

Other Names 1

Doing Business AsHazlehurst Clinic

Other Identifiers 8

Medicaid00113908MS
Medicaid00116996MS
Medicaid00015329MS
Medicaid09013707MS
Medicaid00119484MS
Medicaid00012939MS
Medicaid00011981MS
Medicaid00122024MS

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 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 25D0317528

Hazlehurst Clinic · Hazlehurst, MS
Active · expires Mar 3, 2028
CLIA Number25D0317528
Laboratory TypePhysician Office
Certificate Effective DateMarch 4, 2026
Certificate Expiration DateMarch 3, 2028
Laboratory DirectorFred J. Mc Donnell
Laboratory Phone(601) 894-4661
Laboratory LocationHazlehurst Clinic27190 Highway 28, Ste 102, Hazlehurst, MS 39083
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

DR. RANDY HANKINS MD
Family Medicine
213 CALDWELL DR
HAZLEHURST, MS 39083
Copiah County (601) 894-4661
LAUREN COLEMAN THOMPSON FNP-C
Nurse Practitioner (Family)
213 CALDWELL DR
HAZLEHURST, MS 39083
Copiah County (601) 894-4661
DR. PRESTON MCDONNELL M.D.
Family Medicine
213 CALDWELL DR
HAZLEHURST, MS 39083
Copiah County (601) 894-4661
WILLIAM ALTON SHAW FNP-C
Nurse Practitioner (Family)
213 CALDWELL DR
HAZLEHURST, MS 39083
Copiah County (601) 894-4661
CHRISTOPHER J PRICE FNP-C
Nurse Practitioner (Family)
213 CALDWELL DR
HAZLEHURST, MS 39083
Copiah County (601) 894-4661

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 Copiah County Medical Center's NPI number?

The NPI number for Copiah County Medical Center is 1356448591. It was assigned to this organization in the NPPES registry on September 20, 2006. The provider is doing business as Hazlehurst Clinic.

Where is Copiah County Medical Center located?

Copiah County Medical Center is located at 213 Caldwell Dr, Hazlehurst, MS 39083. The listed phone number is (601) 894-2514.

What is Copiah County Medical Center's specialty?

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

Does Copiah County Medical Center hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D0317528) is associated with this NPI, valid through March 3, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Copiah County Medical Center 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 Copiah County Medical Center 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 Copiah County Medical Center was last updated on September 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.