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DESOTO FAMILY MEDICAL CENTER
NPI 1528150398
Family Medicine in Southaven, MS

Active since September 29, 2006CLIA 25D0671383 · Certificate of Compliance
75 PHYSICIAN LANE, SOUTHAVEN, MS 38671(662) 393-7722(662) 393-7756 Get Directions Write a Review

NPPES record last updated: October 10, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Desoto Family Medical Center NPPES

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

DESOTO FAMILY MEDICAL CENTER (NPI 1528150398) is a healthcare organization registered as a family medicine in Southaven, Mississippi and active in the NPI registry since September 2006. The organization holds a CLIA Certificate of Compliance certificate valid through March 28, 2027 and lists Angel Burnette, Financial Services Manager, as its authorized official.

NPPES Registry Identity

NPI1528150398
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameDESOTO FAMILY MEDICAL CENTER
Location Address75 PHYSICIAN LANESouthaven, MS 38671
Mailing Address75 Physician LaneSouthaven, MS 38671 · (662) 393-7722 · Fax (662) 393-7756
Phone(662) 393-7722
Fax(662) 393-7756
Organization SubpartNo
Authorized OfficialAngel BurnetteFinancial Services Manager · (662) 280-6233
Enumeration DateSeptember 29, 2006
Last NPPES UpdateOctober 10, 2008
✔ NPI 1528150398 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.
75 PHYSICIAN LANE, Southaven, MS 38671
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Other Identifiers 1

Medicare NSC0520300001MS

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 Compliance 25D0671383

Desoto Family Medical Center · Southaven, MS
Active · expires Mar 28, 2027
CLIA Number25D0671383
Laboratory TypePhysician Office
Certificate Effective DateMarch 29, 2025
Certificate Expiration DateMarch 28, 2027
Laboratory DirectorTroy Morris
Laboratory Phone(662) 393-7722
Laboratory LocationDesoto Family Medical Center75 Physicians Lane, Southaven, MS 38671
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Desoto Family Medical Center's NPI number?

The NPI number for Desoto Family Medical Center is 1528150398. It was assigned to this organization in the NPPES registry on September 29, 2006.

Where is Desoto Family Medical Center located?

Desoto Family Medical Center is located at 75 Physician Lane, Southaven, MS 38671. The listed phone number is (662) 393-7722.

What is Desoto Family Medical Center's specialty?

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

Does Desoto Family Medical Center hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 25D0671383) is associated with this NPI, valid through March 28, 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 Desoto Family Medical Center was last updated on October 10, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.