DESOTO FAMILY MEDICAL CENTER
NPI 1528150398
Family Medicine in Southaven, MS
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
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Desoto Family Medical Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
8Medicare enrollment records show 8 clinicians reassign Medicare billing to Desoto Family Medical Center, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 4 within 10 miles. They are listed nearest first.
Clinicians, nearest first (8)
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 Compliance 25D0671383
Desoto Family Medical Center · Southaven, 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 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.
Is Desoto Family Medical Center enrolled in Medicare?
Yes. Desoto Family Medical Center is registered in the Medicare PECOS enrollment system.
When is Desoto Family Medical Center's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Mississippi, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Desoto Family Medical Center?
According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 3 Medicare specialties reassign their Medicare billing to Desoto Family Medical Center. 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. The largest specialties are Nurse Practitioner (4), Family Practice (3) and Internal Medicine (1). Of these, 2 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
What insurance does Desoto Family Medical Center accept?
Health plans from Cigna Healthcare list Desoto Family Medical Center 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 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 18 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.
# Desoto Family Medical Center · NPI 1528150398
Family Medicine organization in Southaven, Mississippi. Organization record, active in the CMS NPPES registry since September 29, 2006.
## Identity
- **NPI:** 1528150398 (Entity type: Organization)
- **Enumerated:** September 29, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Angel Burnette, FINANCIAL SERVICES MANAGER
## Practice location
- **Address:** 75 PHYSICIAN LANE, Southaven, MS 38671
- **Phone:** (662) 393-7722 · **Fax:** (662) 393-7756
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Mississippi, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 8 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (4), Family Practice (3), Internal Medicine (1); 2 practice at this address and 4 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 10, 2008
- **Other identifiers:** Medicare NSC 0520300001 (MS)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1528150398) · Data from the CMS NPPES public registry.