PREMIER HEALTH & WELLNESS CLINIC
NPI 1366108805
Nurse Practitioner - Primary Care in Natchez, MS
About Premier Health & Wellness Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PREMIER HEALTH & WELLNESS CLINIC (NPI 1366108805) is a healthcare organization registered as a primary care in Natchez, Mississippi and active in the NPI registry since November 2021. The organization holds a CLIA Waiver certificate valid through November 30, 2026 and lists Raven Mishael Campbell-smith, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
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)
Premier Health & Wellness Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 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
Medicare enrollment records show 1 clinician reassigns Medicare billing to Premier Health & Wellness Clinic, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 25D2087561
Premier Health & Wellness Clinic · Natchez, 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 Premier Health & Wellness Clinic's NPI number?
The NPI number for Premier Health & Wellness Clinic is 1366108805. It was assigned to this organization in the NPPES registry on November 9, 2021.
Where is Premier Health & Wellness Clinic located?
Premier Health & Wellness Clinic is located at 300 Highland Blvd Ste B, Natchez, MS 39120. The listed phone number is (601) 304-2421.
What is Premier Health & Wellness Clinic's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.
Is Premier Health & Wellness Clinic enrolled in Medicare?
Yes. Premier Health & Wellness Clinic is registered in the Medicare PECOS enrollment system.
When is Premier Health & Wellness Clinic'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 February 28, 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 Premier Health & Wellness Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Premier Health & Wellness Clinic. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Premier Health & Wellness Clinic hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 25D2087561) is associated with this NPI, valid through November 30, 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 Premier Health & Wellness Clinic was last updated on March 18, 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.
# Premier Health & Wellness Clinic · NPI 1366108805
Primary Care organization in Natchez, Mississippi. Organization record, active in the CMS NPPES registry since November 9, 2021.
## Identity
- **NPI:** 1366108805 (Entity type: Organization)
- **Enumerated:** November 9, 2021
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **Organization subpart:** No
- **Authorized official:** Raven Campbell-Smith, OWNER
## Practice location
- **Address:** 300 HIGHLAND BLVD STE B, Natchez, MS 39120-4600
- **Phone:** (601) 304-2421 · **Fax:** (601) 446-6428
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, Mississippi, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 18, 2022
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1366108805) · Data from the CMS NPPES public registry.