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OLIVE BRANCH FAMILY MEDICAL CENTER
NPI 1629018478
Family Medicine in Olive Branch, MS

Active since June 08, 2006CLIA 25D0927270 · Certificate of Compliance
9075 SANDIDGE CENTER CV, OLIVE BRANCH, MS 38654(662) 895-4949(662) 895-6776 Get Directions Write a Review

NPPES record last updated: December 21, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 21, 2020, Mar 17, 2018, Jul 25, 2017 (3 updates tracked since 2017).

About Olive Branch Family Medical Center NPPES

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

OLIVE BRANCH FAMILY MEDICAL CENTER (NPI 1629018478) is a healthcare organization registered as a family medicine in Olive Branch, Mississippi and active in the NPI registry since June 2006. The organization holds a CLIA Certificate of Compliance certificate valid through June 11, 2028, maintains a secondary practice location in Olive Branch, and lists Amy Green, Business Office Manager, as its authorized official.

NPPES Registry Identity

NPI1629018478
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameOLIVE BRANCH FAMILY MEDICAL CENTER
Location Address9075 SANDIDGE CENTER CVOlive Branch, MS 38654-3514
Mailing Address9075 Sandidge Center CvOlive Branch, MS 38654-3514 · (662) 895-4949 · Fax (662) 895-6776
Phone(662) 895-4949
Fax(662) 895-6776
Organization SubpartNo
Authorized OfficialAmy GreenBusiness Office Manager · (662) 893-8484
Enumeration DateJune 8, 2006
Last NPPES UpdateDecember 21, 20203 updates tracked since enumeration
NPPES CertifiedDecember 21, 2020
✔ NPI 1629018478 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.
9075 SANDIDGE CENTER CV, Olive Branch, MS 38654
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Secondary Practice Location 1

Location 18135 Goodman RdOlive Branch, MS 38654-2103 · Phone (662) 895-4949 · Fax (662) 893-1103

Other Identifiers 1

Other1629018478Npi

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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 25D0927270

Olive Branch Family Medical Center · Olive Branch, MS
Active · expires Jun 11, 2028
CLIA Number25D0927270
Laboratory TypePhysician Office
Certificate Effective DateJune 12, 2026
Certificate Expiration DateJune 11, 2028
Laboratory DirectorDr. Randall T. Huling
Laboratory Phone(662) 895-4949
Laboratory LocationOlive Branch Family Medical Center9075 Sandidge Center Cove, Olive Branch, MS 38654
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.

Other Providers at the Same Location NPPES 11

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

KORI SWEARENGEN FNP-BC
Nurse Practitioner (Family)
9075 SANDIDGE CENTER CV
OLIVE BRANCH, MS 38654
Desoto County (662) 895-4949
VIRGINIA HOLMES FNP
Nurse Practitioner (Family)
9075 SANDIDGE CENTER CV
OLIVE BRANCH, MS 38654
Desoto County (662) 895-4949
SHERI S LEDFORD FNP
Nurse Practitioner
9075 SANDIDGE CENTER CV
OLIVE BRANCH, MS 38654
Desoto County (662) 895-4949
ROBERT-MATTHEW HALL NP
Nurse Practitioner (Family)
9075 SANDIDGE CENTER CV
OLIVE BRANCH, MS 38654
Desoto County (662) 895-4949
DR. RANDALL T HULING MD
Family Medicine
9075 SANDIDGE CENTER CV
OLIVE BRANCH, MS 38654
Desoto County (662) 895-4949
LEON C TURNER NP
Nurse Practitioner
9075 SANDIDGE CENTER CV
OLIVE BRANCH, MS 38654
Desoto County (662) 895-4949
OLIVE BRANCH VISION SPECIALISTS PLLC
Ophthalmology
9075 SANDIDGE CENTER CV
OLIVE BRANCH, MS 38654
Desoto County (901) 871-2373
ATRICIA R WHITE FNP
Nurse Practitioner
9075 SANDIDGE CENTER CV
OLIVE BRANCH, MS 38654
Desoto County (662) 895-4949

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 Olive Branch Family Medical Center's NPI number?

The NPI number for Olive Branch Family Medical Center is 1629018478. It was assigned to this organization in the NPPES registry on June 8, 2006.

Where is Olive Branch Family Medical Center located?

Olive Branch Family Medical Center is located at 9075 Sandidge Center Cv, Olive Branch, MS 38654. The listed phone number is (662) 895-4949.

What is Olive Branch Family Medical Center's specialty?

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

Does Olive Branch Family Medical Center hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 25D0927270) is associated with this NPI, valid through June 11, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Olive Branch Family Medical Center was last updated on December 21, 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.