SOUTH RANKIN FAMILY CLINIC, LLC
NPI 1629143334
Family Medicine in Richland, MS
About South Rankin Family Clinic, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTH RANKIN FAMILY CLINIC, LLC (NPI 1629143334) is a healthcare organization registered as a family medicine in Richland, Mississippi and active in the NPI registry since November 2006. The organization lists Roderick Anthony Shields, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
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)
South Rankin Family Clinic, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
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
2Medicare enrollment records show 2 clinicians reassign Medicare billing to South Rankin Family Clinic, LLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 South Rankin Family Clinic, LLC's NPI number?
The NPI number for South Rankin Family Clinic, LLC is 1629143334. It was assigned to this organization in the NPPES registry on November 21, 2006.
Where is South Rankin Family Clinic, LLC located?
South Rankin Family Clinic, LLC is located at 368 Scarbrough St Suite B, Richland, MS 39218. The listed phone number is (601) 664-2273.
What is South Rankin Family Clinic, LLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is South Rankin Family Clinic, LLC enrolled in Medicare?
Yes. South Rankin Family Clinic, LLC is registered in the Medicare PECOS enrollment system.
When is South Rankin Family Clinic, LLC'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 January 31, 2027. 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 South Rankin Family Clinic, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to South Rankin Family Clinic, LLC, in Family Practice and Nurse Practitioner. 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. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for South Rankin Family Clinic, LLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# South Rankin Family Clinic, Llc · NPI 1629143334
Family Medicine organization in Richland, Mississippi. Organization record, active in the CMS NPPES registry since November 21, 2006.
## Identity
- **NPI:** 1629143334 (Entity type: Organization)
- **Enumerated:** November 21, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Roderick Shields, OWNER
## Practice location
- **Address:** 368 SCARBROUGH ST, SUITE B, Richland, MS 39218-9038
- **Phone:** (601) 664-2273 · **Fax:** (601) 664-3472
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Mississippi, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (1), Nurse Practitioner (1); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 22, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1629143334) · Data from the CMS NPPES public registry.