CLARKSDALE FAM MED CENTER
NPI 1467949941
Family Medicine in Clarksdale, MS

Q: What is Delta Medical Foundation's NPI number?

The NPI number for Delta Medical Foundation is 1467949941. It was assigned to this organization in the NPPES registry on April 19, 2018. The provider is doing business as Clarksdale Fam Med Center.

Q: What is Delta Medical Foundation's specialty?

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

Active since April 19, 2018CLIA 25D2281590 · Waiver

1209 LEE DR, CLARKSDALE, MS 38614(662) 326-3500(662) 326-7077 Get Directions Write a Review

NPPES record last updated: March 1, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 1, 2023, Jul 22, 2020, Apr 19, 2018 (3 updates tracked since 2018).

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About Clarksdale Fam Med Center NPPES

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

CLARKSDALE FAM MED CENTER (NPI 1467949941) is a healthcare organization registered as a family medicine in Clarksdale, Mississippi and active in the NPI registry since April 2018. The organization holds a CLIA Waiver certificate valid through May 8, 2027 and lists Lonnie Moore, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1467949941

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameDELTA MEDICAL FOUNDATION

Location Address1209 LEE DRClarksdale, MS 38614-3320

Mailing AddressPo Box 289Marks, MS 38646-0289 · (662) 398-5111 · Fax (662) 398-7123

Phone(662) 326-3500

Fax(662) 326-7077

Organization SubpartNo

Authorized OfficialLonnie MooreExecutive Director · (662) 326-3500

Enumeration DateApril 19, 2018

Last NPPES UpdateMarch 1, 20233 updates tracked since enumeration

NPPES CertifiedMarch 1, 2023

✔ NPI 1467949941 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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.

Also ListedClinic/Center · Rural HealthTaxonomy 261QR1300X

1209 LEE DR, Clarksdale, MS 38614

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Other Names 1

Doing Business AsClarksdale Fam Med Center

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 25D2281590

Clarksdale Family Medical Center · Clarksdale, MS

Active · expires May 8, 2027

CLIA Number25D2281590

Laboratory TypePhysician Office

Certificate Effective DateMay 9, 2025

Certificate Expiration DateMay 8, 2027

Laboratory DirectorDr. Richard E. Waller

Laboratory Phone(662) 326-3500

Laboratory LocationClarksdale Family Medical Center1209 Lee Dr, Clarksdale, MS 38614

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

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 Delta Medical Foundation's NPI number?

The NPI number for Delta Medical Foundation is 1467949941. It was assigned to this organization in the NPPES registry on April 19, 2018. The provider is doing business as Clarksdale Fam Med Center.

Where is Delta Medical Foundation located?

Delta Medical Foundation is located at 1209 Lee Dr, Clarksdale, MS 38614. The listed phone number is (662) 326-3500.

What is Delta Medical Foundation's specialty?

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

Does Delta Medical Foundation hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2281590) is associated with this NPI, valid through May 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Delta Medical Foundation 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 Delta Medical Foundation 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 Delta Medical Foundation was last updated on March 1, 2023. 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.