MISSION PRIMARY CARE CLINIC PLLC
NPI 1487852018
Family Medicine in Vicksburg, MS
About Mission Primary Care Clinic Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MISSION PRIMARY CARE CLINIC PLLC (NPI 1487852018) is a healthcare organization registered as a family medicine in Vicksburg, Mississippi and active in the NPI registry since July 2007. The organization holds a CLIA Certificate of Compliance certificate valid through July 5, 2028 and lists Bill Fulcher, Adm, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 1
Group Practice 1
Accepted 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 Compliance 25D0901653
Mission Primary Care Clinic · Vicksburg, MSOther Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
VICKSBURG, MS 39180
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 Mission Primary Care Clinic PLLC's NPI number?
The NPI number for Mission Primary Care Clinic PLLC is 1487852018. It was assigned to this organization in the NPPES registry on July 5, 2007.
Where is Mission Primary Care Clinic PLLC located?
Mission Primary Care Clinic PLLC is located at 1901 Mission 66, Vicksburg, MS 39180. The listed phone number is (601) 636-0097.
What is Mission Primary Care Clinic PLLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Does Mission Primary Care Clinic PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 25D0901653) is associated with this NPI, valid through July 5, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Mission Primary Care Clinic PLLC 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 list Mission Primary Care Clinic PLLC 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 Mission Primary Care Clinic PLLC was last updated on May 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Mission Primary Care Clinic Pllc · NPI 1487852018
Family Medicine organization in Vicksburg, Mississippi. Organization record, active in the CMS NPPES registry since July 5, 2007.
## Identity
- **NPI:** 1487852018 (Entity type: Organization)
- **Enumerated:** July 5, 2007
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Bill Fulcher, ADM
## Practice location
- **Address:** 1901 MISSION 66, Vicksburg, MS 39180-3711
- **Phone:** (601) 636-0097 · **Fax:** (601) 629-9969
## Record status
- **NPPES last updated:** May 25, 2022
- **Other identifiers:** Medicaid 04935090 (MS)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1487852018) · Data from the CMS NPPES public registry.