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SHANNON FAMILY MEDICAL CLINIC, LLC
NPI 1568633964
Clinic/Center - Rural Health in Shannon, MS

Active since March 13, 2008
219 BROAD ST, SHANNON, MS 38868(662) 995-2201(662) 995-2202 Get Directions Write a Review

NPPES record last updated: June 25, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 25, 2018, Jun 19, 2018 (2 updates tracked since 2018).

About Shannon Family Medical Clinic, Llc NPPES

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

SHANNON FAMILY MEDICAL CLINIC, LLC (NPI 1568633964) is a healthcare organization registered as a rural health in Shannon, Mississippi and active in the NPI registry since March 2008. The organization lists Norris N Doss, Owner, as its authorized official.

NPPES Registry Identity

NPI1568633964
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameSHANNON FAMILY MEDICAL CLINIC, LLC
Location Address219 BROAD STShannon, MS 38868
Mailing Address219 Broad StShannon, MS 38868-9301 · (662) 995-2201 · Fax (662) 995-2202
Phone(662) 995-2201
Fax(662) 995-2202
Organization SubpartNo
Authorized OfficialNorris N DossOwner · (662) 995-2201
Enumeration DateMarch 13, 2008
Last NPPES UpdateJune 25, 20182 updates tracked since enumeration
✔ NPI 1568633964 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
License✔ Licensed in MS · R819576
219 BROAD ST, Shannon, MS 38868
Open in Google Maps ↗

Other Identifiers 1

Medicaid05188209MS

Other Providers at the Same Location NPPES

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

NORRIS DOSS NP
Nurse Practitioner (Family)
219 BROAD ST
SHANNON, MS 38868
Lee County (662) 995-2201

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 Shannon Family Medical Clinic, LLC's NPI number?

The NPI number for Shannon Family Medical Clinic, LLC is 1568633964. It was assigned to this organization in the NPPES registry on March 13, 2008.

Where is Shannon Family Medical Clinic, LLC located?

Shannon Family Medical Clinic, LLC is located at 219 Broad St, Shannon, MS 38868. The listed phone number is (662) 995-2201.

What is Shannon Family Medical Clinic, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

When was this NPI record last updated?

The NPPES record for Shannon Family Medical Clinic, LLC was last updated on June 25, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.