JFMC ELLISVILLE, LLC
NPI 1407121338
Clinic/Center - Primary Care in Ellisville, MS
About Jfmc Ellisville, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JFMC ELLISVILLE, LLC (NPI 1407121338) is a healthcare organization registered as a primary care in Ellisville, Mississippi and active in the NPI registry since March 2012. The organization holds a CLIA Waiver certificate valid through July 26, 2028 and lists Kaye D Jones, Office Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jfmc Ellisville, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
25Medicare enrollment records show 25 clinicians reassign Medicare billing to Jfmc Ellisville, LLC, which bills Medicare for the services they deliver. Of these, 5 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 2
Nearest to this location (20)
See all 25Source: 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 25D2053253
Jfmc Ellisville LLC · Ellisville, 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 Jfmc Ellisville, LLC's NPI number?
The NPI number for Jfmc Ellisville, LLC is 1407121338. It was assigned to this organization in the NPPES registry on March 10, 2012.
Where is Jfmc Ellisville, LLC located?
Jfmc Ellisville, LLC is located at 602 Hill St, Ellisville, MS 39437. The listed phone number is (601) 719-0092.
What is Jfmc Ellisville, LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Jfmc Ellisville, LLC enrolled in Medicare?
Yes. Jfmc Ellisville, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Jfmc Ellisville, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 25 clinicians in 2 Medicare specialties reassign their Medicare billing to Jfmc Ellisville, LLC. 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 Nurse Practitioner (24) and Family Practice (1). Of these, 5 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Jfmc Ellisville, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 25D2053253) is associated with this NPI, valid through July 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Jfmc Ellisville, LLC was last updated on October 18, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Jfmc Ellisville, Llc · NPI 1407121338
Primary Care organization in Ellisville, Mississippi. Organization record, active in the CMS NPPES registry since March 10, 2012.
## Identity
- **NPI:** 1407121338 (Entity type: Organization)
- **Enumerated:** March 10, 2012
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** Yes (part of Jones Family Medicine Clinic, Pllc)
- **Authorized official:** Kaye Jones, OFFICE MANAGER
## Practice location
- **Address:** 602 HILL ST, Ellisville, MS 39437-2414
- **Phone:** (601) 719-0092 · **Fax:** (601) 719-0473
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 25 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (24), Family Practice (1); 5 practice within 10 miles; [full list](https://npiprofile.com/npi/1407121338/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 18, 2012
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1407121338) · Data from the CMS NPPES public registry.