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EAST-END FAMILY MEDICAL CLINIC, LLC
NPI 1487118733
Clinic/Center - Primary Care in Cleveland, MS

Active since January 30, 2019CLIA 25D2161758 · Waiver
140 NORTH ST, CLEVELAND, MS 38732(662) 545-4674(662) 545-4715 Get Directions Write a Review

NPPES record last updated: January 17, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 20, 2022, Jan 30, 2019 (2 updates tracked since 2019).

About East-end Family Medical Clinic, Llc NPPES

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

EAST-END FAMILY MEDICAL CLINIC, LLC (NPI 1487118733) is a healthcare organization registered as a primary care in Cleveland, Mississippi and active in the NPI registry since January 2019. The organization holds a CLIA Waiver certificate valid through February 10, 2027 and lists Cassandra Latasha Shepard, Fnp/administrator, as its authorized official.

NPPES Registry Identity

NPI1487118733
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameEAST-END FAMILY MEDICAL CLINIC, LLC
Location Address140 NORTH STCleveland, MS 38732-2744
Mailing Address1500 N Bayou RdCleveland, MS 38732-9723 · (662) 721-8036
Phone(662) 545-4674
Fax(662) 545-4715
Organization SubpartNo
Authorized OfficialCassandra Latasha ShepardFnp/administrator · (662) 545-4674
Enumeration DateJanuary 30, 2019
Last NPPES UpdateJanuary 17, 20242 updates tracked since enumeration
NPPES CertifiedJanuary 17, 2024
✔ NPI 1487118733 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
140 NORTH ST, Cleveland, MS 38732
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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 25D2161758

East End Family Medical Clinic · Cleveland, MS
Active · expires Feb 10, 2027
CLIA Number25D2161758
Laboratory TypePractitioner Other
Certificate Effective DateFebruary 11, 2025
Certificate Expiration DateFebruary 10, 2027
Laboratory DirectorCassandra L. Shepard
Laboratory Phone(662) 545-4674
Laboratory LocationEast End Family Medical Clinic140 North St, Cleveland, MS 38732
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CASSANDRA LATASHA SHEPARD FNP
Nurse Practitioner
140 NORTH ST
CLEVELAND, MS 38732
Bolivar County (662) 545-4674
CLEVELAND FOOT CLINIC INC
Podiatrist (Primary Podiatric Medicine)
140 NORTH ST
CLEVELAND, MS 38732
Bolivar County (662) 843-3668
CHARLES E HICKS
Podiatrist (Primary Podiatric Medicine)
140 NORTH ST
CLEVELAND, MS 38732
Bolivar County (662) 843-3668
EAST-END FAMILY MEDICAL CLINIC, LLC
Clinic/Center (Rural Health)
140 NORTH ST
CLEVELAND, MS 38732
Bolivar County (662) 545-4674

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 East-End Family Medical Clinic, LLC's NPI number?

The NPI number for East-End Family Medical Clinic, LLC is 1487118733. It was assigned to this organization in the NPPES registry on January 30, 2019.

Where is East-End Family Medical Clinic, LLC located?

East-End Family Medical Clinic, LLC is located at 140 North St, Cleveland, MS 38732. The listed phone number is (662) 545-4674.

What is East-End Family Medical Clinic, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does East-End Family Medical Clinic, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2161758) is associated with this NPI, valid through February 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does East-End Family Medical Clinic, LLC 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 East-End Family Medical Clinic, LLC 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 East-End Family Medical Clinic, LLC was last updated on January 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.