HAZLEHURST CLINIC
NPI 1356448591
Family Medicine in Hazlehurst, MS
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
Specialties & Licenses
Other Names 1
Other Identifiers 8
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Hazlehurst Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
10Medicare enrollment records show 10 clinicians reassign Medicare billing to Hazlehurst Clinic, which bills Medicare for the services they deliver. Of these, 6 practice at this address and 8 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 2
Clinicians, nearest first (10)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, MSFrequently 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.
Is Copiah County Medical Center enrolled in Medicare?
Yes. Copiah County Medical Center is registered in the Medicare PECOS enrollment system.
When is Copiah County Medical Center's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Mississippi, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Copiah County Medical Center?
According to the CMS Revalidation Reassignment List (October 2026 release), 10 clinicians in 2 Medicare specialties reassign their Medicare billing to Copiah County Medical Center. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Family Practice (6) and Nurse Practitioner (4). Of these, 6 practice at this address and 8 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, 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 4 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.
# Hazlehurst Clinic · NPI 1356448591
Family Medicine organization in Hazlehurst, Mississippi. Organization record, active in the CMS NPPES registry since September 20, 2006.
## Identity
- **NPI:** 1356448591 (Entity type: Organization)
- **Enumerated:** September 20, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Copiah County Medical Center
- **Organization subpart:** Yes (part of Copiah County Medical Center)
- **Authorized official:** Kortney Gaddy, CFO
## Practice location
- **Address:** 213 CALDWELL DR, Hazlehurst, MS 39083
- **Phone:** (601) 894-2514 · **Fax:** (601) 894-2514
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Mississippi, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 10 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (6), Nurse Practitioner (4); 6 practice at this address and 8 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 22, 2022
- **Other identifiers:** Medicaid 00113908 (MS); Medicaid 00116996 (MS); Medicaid 00015329 (MS); and 5 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1356448591) · Data from the CMS NPPES public registry.