121 MEDICAL PLACE, INC
NPI 1588106553
Clinic/Center - Community Health in Mendenhall, MS
NPI Status: Active since November 08, 2016
Contact Information
820 MANGUM AVE
MENDENHALL, MS
ZIP 39114
Phone: (601) 906-1897
- Organization
- Clinic/Center
- Community Health
- Accepts Insurance
- CLIA Number: 25D0317604
- CLIA Cert. Type: Practitioner Other
- CLIA Exp. Date: 02-06-2027
About 121 MEDICAL PLACE, INC
This page provides the complete NPI Profile along with additional information for 121 Medical Place, Inc, a primary care provider established in Mendenhall, Mississippi operating as a Clinic/center, focusing in community health . The healthcare provider is registered in the NPI registry with number 1588106553 assigned on November 2016. The practitioner's primary taxonomy code is 261QC1500X with license number R863242 (MS). The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Shelley Leach Fnp-c (President)
- NPI
- 1588106553
- Provider Name
- 121 MEDICAL PLACE, INC
- Entity Type
- Organization
- Location Address
- 820 MANGUM AVE MENDENHALL, MS 39114
- Location Phone
- (601) 906-1897
- Mailing Address
- 820 MANGUM AVE MENDENHALL, MS 39114
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-08-2016
- Last Update Date
- 08-06-2025
- Code Navigator
A primary care provider (PCP) like 121 Medical Place, Inc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Community Health
- Taxonomy Code
- 261QC1500X
- Type
- Ambulatory Health Care Facilities
- License No.
- R863242
- License State
- MS
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Molina Gold Standard - HMO
- Molina Silver Standard - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 00476391 | MEDICAID (05) | MS |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 25D0317604
- Facility Type
- Practitioner Other
- Certificate Effective Date
- February 07, 2025
- Certificate Expiration Date
- February 06, 2027
- Laboratory Director
- SHELLEY S. LEACH
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to 121 Medical Place, Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for 121 MEDICAL PLACE, INC
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1588106553, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 57 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1588106553, enumerated as an "organization" on November 08, 2016.
The provider is located at 820 MANGUM AVE MENDENHALL, MS 39114 and the phone number is (601) 906-1897.
Clinic/Center with taxonomy code 261QC1500X and a focus in Community Health.
The provider might be accepting Accepts: Molina Healthcare, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
