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WOODLAND CLINIC LLC
NPI 1629282330
Family Medicine - Hospice and Palliative Medicine in Woodland, MS

Active since May 10, 2007CLIA 25D0944715 · Microscopy
120 MARKET ST, WOODLAND, MS 39776(662) 456-0111(662) 456-7335 Get Directions Write a Review

NPPES record last updated: January 29, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Woodland Clinic Llc NPPES

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

WOODLAND CLINIC LLC (NPI 1629282330) is a healthcare organization registered as a hospice and palliative medicine in Woodland, Mississippi and active in the NPI registry since May 2007. The organization holds a CLIA Microscopy certificate valid through April 16, 2028 and lists Jerry Sullivan, Owner, as its authorized official.

NPPES Registry Identity

NPI1629282330
Entity TypeOrganization
Primary Taxonomy207QH0002X
Legal Business NameWOODLAND CLINIC LLC
Location Address120 MARKET STWoodland, MS 39776-9104
Mailing AddressPo Box 186Woodland, MS 39776-0186 · (662) 456-0111 · Fax (662) 456-7335
Phone(662) 456-0111
Fax(662) 456-7335
Organization SubpartNo
Authorized OfficialJerry SullivanOwner · (662) 456-0111
Enumeration DateMay 10, 2007
Last NPPES UpdateJanuary 29, 2011
✔ NPI 1629282330 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Hospice and Palliative MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QH0002X
Definition
A family medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care.
120 MARKET ST, Woodland, MS 39776
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Other Names 1

Former Legal Business NameWoodland Clinic Llc

Other Identifiers 6

Medicare OSCAR/certification258937MS
Medicare UPINC48284MS
Medicare UPINS69279MS
Medicaid09014809MS
Medicaid0114346MS
Medicaid0112415MS

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 MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

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 for Provider-Performed Microscopy Procedures (PPMP) 25D0944715

Woodland Clinic LLC · Woodland, MS
Active · expires Apr 16, 2028
CLIA Number25D0944715
Laboratory TypePractitioner Other
Certificate Effective DateApril 17, 2026
Certificate Expiration DateApril 16, 2028
Laboratory DirectorJerrie L. Sullivan
Laboratory Phone(662) 456-0111
Laboratory LocationWoodland Clinic LLC120 Market Street, Woodland, MS 39776
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 2

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

JESSICA SULLIVAN CFNP
Nurse Practitioner (Primary Care)
120 MARKET ST
WOODLAND, MS 39776
Chickasaw County (662) 456-0111
FOOT SOLUTIONS LLC
Pharmacy (Clinic Pharmacy)
120 MARKET ST
WOODLAND, MS 39776
Chickasaw County (662) 456-0133

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 Woodland Clinic LLC's NPI number?

The NPI number for Woodland Clinic LLC is 1629282330. It was assigned to this organization in the NPPES registry on May 10, 2007.

Where is Woodland Clinic LLC located?

Woodland Clinic LLC is located at 120 Market St, Woodland, MS 39776. The listed phone number is (662) 456-0111.

What is Woodland Clinic LLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Hospice and Palliative Medicine, with taxonomy code 207QH0002X.

Does Woodland Clinic LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 25D0944715) is associated with this NPI, valid through April 16, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Woodland Clinic LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee and 1 other insurer list Woodland Clinic LLC 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 Woodland Clinic LLC was last updated on January 29, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.