WINSTON MEDICAL CLINIC LLC
NPI 1629417324
Clinic/Center - Rural Health in Louisville, MS
About Winston Medical Clinic Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WINSTON MEDICAL CLINIC LLC (NPI 1629417324) is a healthcare organization registered as a rural health in Louisville, Mississippi and active in the NPI registry since June 2013. The organization holds a CLIA Certificate of Compliance certificate valid through July 28, 2028 and lists Debbie J Fryery, Director Of Clinic Operations, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Winston Medical Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
12Medicare enrollment records show 12 clinicians reassign Medicare billing to Winston Medical Clinic LLC, which bills Medicare for the services they deliver. Of these, 11 practice within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 2
Clinicians, nearest first (12)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 25D1007731
Winston Medical Clinic LLC · Louisville, MSFrequently 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 Winston Medical Clinic LLC's NPI number?
The NPI number for Winston Medical Clinic LLC is 1629417324. It was assigned to this organization in the NPPES registry on June 17, 2013.
Where is Winston Medical Clinic LLC located?
Winston Medical Clinic LLC is located at 923 S Church Ave, Louisville, MS 39339. The listed phone number is (662) 773-3503.
What is Winston Medical Clinic LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.
Is Winston Medical Clinic LLC enrolled in Medicare?
Yes. Winston Medical Clinic LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Winston Medical Clinic LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 12 clinicians in 2 Medicare specialties reassign their Medicare billing to Winston Medical Clinic LLC. 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. The largest specialties are Nurse Practitioner (8) and Family Practice (4). Of these, 11 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Winston Medical Clinic LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 25D1007731) is associated with this NPI, valid through July 28, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Winston Medical Clinic LLC accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 1 other insurer list Winston Medical 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 Winston Medical Clinic LLC was last updated on January 19, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Winston Medical Clinic Llc · NPI 1629417324
Rural Health organization in Louisville, Mississippi. Organization record, active in the CMS NPPES registry since June 17, 2013.
## Identity
- **NPI:** 1629417324 (Entity type: Organization)
- **Enumerated:** June 17, 2013
- **Primary specialty:** Clinic/Center - Rural Health · taxonomy 261QR1300X
- **Organization subpart:** No
- **Authorized official:** Debbie Fryery, DIRECTOR OF CLINIC OPERATIONS
## Practice location
- **Address:** 923 S CHURCH AVE, Louisville, MS 39339
- **Phone:** (662) 773-3503 · **Fax:** (662) 446-1039
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 12 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (8), Family Practice (4); 11 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 19, 2017
- **Other identifiers:** Medicaid 01689827 (MS); Medicare OSCAR/certification 258593 (MS)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1629417324) · Data from the CMS NPPES public registry.