INTERNAL MEDICINE CLINIC OF CLARKSDALE
NPI 1457554479
Specialist in Clarksdale, MS
About Internal Medicine Clinic Of Clarksdale NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
INTERNAL MEDICINE CLINIC OF CLARKSDALE (NPI 1457554479) is a healthcare organization registered as a specialist in Clarksdale, Mississippi and active in the NPI registry since June 2007. The organization holds a CLIA Waiver certificate valid through October 12, 2028, maintains a secondary practice location in Clarksdale, and lists Sandra Blount, Office Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Internal Medicine Clinic Of Clarksdale is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Internal Medicine Clinic Of Clarksdale, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
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 25D0958993
Internal Medicine Clinic · Clarksdale, 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 Internal Medicine Clinic Of Clarksdale's NPI number?
The NPI number for Internal Medicine Clinic Of Clarksdale is 1457554479. It was assigned to this organization in the NPPES registry on June 7, 2007.
Where is Internal Medicine Clinic Of Clarksdale located?
Internal Medicine Clinic Of Clarksdale is located at 1967 Hospital Dr, Clarksdale, MS 38614. The listed phone number is (662) 624-5481.
What is Internal Medicine Clinic Of Clarksdale's specialty?
The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.
Is Internal Medicine Clinic Of Clarksdale enrolled in Medicare?
Yes. Internal Medicine Clinic Of Clarksdale is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Internal Medicine Clinic Of Clarksdale?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Internal Medicine Clinic Of Clarksdale, in Internal Medicine and Nurse Practitioner. 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Internal Medicine Clinic Of Clarksdale hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 25D0958993) is associated with this NPI, valid through October 12, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Internal Medicine Clinic Of Clarksdale 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 Internal Medicine Clinic Of Clarksdale 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 Internal Medicine Clinic Of Clarksdale was last updated on January 14, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Internal Medicine Clinic Of Clarksdale · NPI 1457554479
Specialist organization in Clarksdale, Mississippi. Organization record, active in the CMS NPPES registry since June 7, 2007.
## Identity
- **NPI:** 1457554479 (Entity type: Organization)
- **Enumerated:** June 7, 2007
- **Primary specialty:** Specialist · taxonomy 174400000X
- **Organization subpart:** No
- **Authorized official:** Sandra Blount, OFFICE MANAGER
## Practice location
- **Address:** 1967 HOSPITAL DR, Clarksdale, MS 38614-7203
- **Phone:** (662) 624-5481
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Internal Medicine (1), Nurse Practitioner (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 14, 2019
- **Other identifiers:** Medicaid 07922048 (MS); Medicaid 00119669 (MS)
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1457554479) · Data from the CMS NPPES public registry.