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IMMEDIATE CARE- PETAL
NPI 1497162234
Family Medicine in Petal, MS

Active since July 14, 2014CLIA 25D2072189 · Waiver
50 PARKWAY LN, PETAL, MS 39465(601) 705-2897(601) 584-6457 Get Directions Write a Review

NPPES record last updated: February 18, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Immediate Care- Petal NPPES

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

IMMEDIATE CARE- PETAL (NPI 1497162234) is a healthcare organization registered as a family medicine in Petal, Mississippi and active in the NPI registry since July 2014. The organization holds a CLIA Waiver certificate valid through April 8, 2027 and lists Bryan N Batson, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1497162234
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameHATTIESBURG CLINIC, PA
Location Address50 PARKWAY LNPetal, MS 39465-3035
Mailing Address415 S 28th AveHattiesburg, MS 39401-7246 · (601) 579-5463 · Fax (601) 579-5240
Phone(601) 705-2897
Fax(601) 584-6457
Organization SubpartNo
Authorized OfficialBryan N BatsonExecutive Director · (601) 264-6000
Enumeration DateJuly 14, 2014
Last NPPES UpdateFebruary 18, 2021
NPPES CertifiedFebruary 18, 2021
✔ NPI 1497162234 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
50 PARKWAY LN, Petal, MS 39465
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Other Names 1

Doing Business AsImmediate Care- Petal

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 25D2072189

Hattiesburg Clinic Clinical Research · Petal, MS
Active · expires Apr 8, 2027
CLIA Number25D2072189
Laboratory TypeClinical Research Office
Certificate Effective DateApril 9, 2025
Certificate Expiration DateApril 8, 2027
Laboratory DirectorDr. Rambod Rouhbakhsh
Laboratory Phone(601) 296-2987
Laboratory LocationHattiesburg Clinic Clinical Research206 Old Corinth Road Ste 3, Petal, MS 39465
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

GEORGE GILLESPIE III D.O.
Family Medicine
50 PARKWAY LN
PETAL, MS 39465
Forrest County (601) 544-7404
RODNEY N LOVITT MD
Family Medicine
50 PARKWAY LN
PETAL, MS 39465
Forrest County (601) 544-7404
MR. WILLIAM PHILLIP FORTENBERRY JR.
Family Medicine
50 PARKWAY LN
PETAL, MS 39465
Forrest County (601) 544-7404
RONALD A BULLOCK MD
Family Medicine
50 PARKWAY LN
PETAL, MS 39465
Forrest County (601) 705-2897
BARBARA MITCHELL KARCHER M.D.
Internal Medicine
50 PARKWAY LN
PETAL, MS 39465
Forrest County (601) 544-7404
JUDD M REYNOLDS D.O.
Family Medicine
50 PARKWAY LN
PETAL, MS 39465
Forrest County (601) 544-7404
HATTIESBURG CLINIC PA
Family Medicine
50 PARKWAY LN
PETAL, MS 39465
Forrest County (601) 544-7404

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 Hattiesburg Clinic, PA's NPI number?

The NPI number for Hattiesburg Clinic, PA is 1497162234. It was assigned to this organization in the NPPES registry on July 14, 2014. The provider is doing business as Immediate Care- Petal.

Where is Hattiesburg Clinic, PA located?

Hattiesburg Clinic, PA is located at 50 Parkway Ln, Petal, MS 39465. The listed phone number is (601) 705-2897.

What is Hattiesburg Clinic, PA's specialty?

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

Does Hattiesburg Clinic, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2072189) is associated with this NPI, valid through April 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Hattiesburg Clinic, PA was last updated on February 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.