CHILDRENS CLINIC OF CLARKSDALE PA
NPI 1497834030
Pediatrics in Clarksdale, MS

Q: What is Childrens Clinic Of Clarksdale PA's NPI number?

The NPI number for Childrens Clinic Of Clarksdale PA is 1497834030. It was assigned to this organization in the NPPES registry on November 3, 2006.

Q: What is Childrens Clinic Of Clarksdale PA's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Active since November 03, 2006

2245 N STATE STREET, CLARKSDALE, MS 38614(662) 627-4131(662) 627-2702 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Childrens Clinic Of Clarksdale Pa NPPES

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

CHILDRENS CLINIC OF CLARKSDALE PA (NPI 1497834030) is a healthcare organization registered as a pediatrics in Clarksdale, Mississippi and active in the NPI registry since November 2006. The organization lists Carole L Mangrem, Partner, as its authorized official.

NPPES Registry Identity

NPI1497834030

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameCHILDRENS CLINIC OF CLARKSDALE PA

Location Address2245 N STATE STREETClarksdale, MS 38614

Mailing AddressPo Box 1447Clarksdale, MS 38614 · (662) 627-4131 · Fax (662) 627-2702

Phone(662) 627-4131

Fax(662) 627-2702

Organization SubpartNo

Authorized OfficialCarole L MangremPartner · (662) 627-4131

Enumeration DateNovember 3, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1497834030 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Licenses✔ Licensed in MS · R861078✔ Licensed in MS · 07191✔ Licensed in MS · 07070

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

2245 N STATE STREET, Clarksdale, MS 38614

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Other Identifiers 1

Medicaid09013997MS

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

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 25D0678162

Children's Clinic, The · Clarksdale, MS

Expired · Jul 31, 2026

CLIA Number25D0678162

Laboratory TypeFederally Qualified Health Center

Certificate Effective DateAugust 1, 2024

Certificate Expiration DateJuly 31, 2026

Laboratory DirectorDr. Yasmin Cheema

Laboratory Phone(662) 624-4292

Laboratory LocationChildren's Clinic, The2245 N State St, Clarksdale, MS 38614

CLIA data matches this NPI record on: Address

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 Childrens Clinic Of Clarksdale PA's NPI number?

The NPI number for Childrens Clinic Of Clarksdale PA is 1497834030. It was assigned to this organization in the NPPES registry on November 3, 2006.

Where is Childrens Clinic Of Clarksdale PA located?

Childrens Clinic Of Clarksdale PA is located at 2245 N State Street, Clarksdale, MS 38614. The listed phone number is (662) 627-4131.

What is Childrens Clinic Of Clarksdale PA's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

What insurance does Childrens Clinic Of Clarksdale PA 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 Childrens Clinic Of Clarksdale PA 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 Childrens Clinic Of Clarksdale PA was last updated on August 22, 2020. 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.