EAST-END FAMILY MEDICAL CLINIC, LLC
NPI 1487118733
Clinic/Center - Primary Care in Cleveland, MS
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
Specialties & Licenses
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)
East-end Family Medical Clinic, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to East-End Family Medical Clinic, LLC, 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 25D2161758
East End Family Medical Clinic · Cleveland, 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 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.
Is East-End Family Medical Clinic, LLC enrolled in Medicare?
Yes. East-End Family Medical Clinic, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through East-End Family Medical Clinic, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to East-End Family Medical Clinic, 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee 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.
# East-End Family Medical Clinic, Llc · NPI 1487118733
Primary Care organization in Cleveland, Mississippi. Organization record, active in the CMS NPPES registry since January 30, 2019.
## Identity
- **NPI:** 1487118733 (Entity type: Organization)
- **Enumerated:** January 30, 2019
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Cassandra Shepard, FNP/ADMINISTRATOR
## Practice location
- **Address:** 140 NORTH ST, Cleveland, MS 38732-2744
- **Phone:** (662) 545-4674 · **Fax:** (662) 545-4715
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **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:** January 17, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1487118733) · Data from the CMS NPPES public registry.