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MISSISSIPPI FAMILY MEDICINE P C
NPI 1669522942
Clinic/Center - Primary Care in Waynesboro, MS

Active since January 11, 2007CLIA 25D0918730 · Waiver
940 MATTHEW DR, SUITE 2, WAYNESBORO, MS 39367(601) 671-8555(601) 671-0777 Get Directions Write a Review

NPPES record last updated: July 20, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mississippi Family Medicine P C NPPES

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

MISSISSIPPI FAMILY MEDICINE P C (NPI 1669522942) is a healthcare organization registered as a primary care in Waynesboro, Mississippi and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through January 27, 2027 and lists Barbara Dearman, Insurance Clerk, as its authorized official.

NPPES Registry Identity

NPI1669522942
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameMISSISSIPPI FAMILY MEDICINE P C
Location Address940 MATTHEW DR, SUITE 2Waynesboro, MS 39367-2522
Mailing Address940 Matthew Dr, Suite 2Waynesboro, MS 39367-2522 · (601) 671-8555 · Fax (601) 671-0777
Phone(601) 671-8555
Fax(601) 671-0777
Organization SubpartNo
Authorized OfficialBarbara DearmanInsurance Clerk · (601) 671-8555
Enumeration DateJanuary 11, 2007
Last NPPES UpdateJuly 20, 2010
✔ NPI 1669522942 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
940 MATTHEW DR, Waynesboro, MS 39367
Open in Google Maps ↗

Other Identifiers 14

OtherCD1005Palmettogba - Railroad Medicare
Other279588MS · Dr. Tynes
Medicare ID-Type Unspecified080002402MS · Dr. Tynes
OtherC02214MS · Medicare Provider Id
Other00964AL · Dr. Stokley
Medicare ID-Type Unspecified080003076MS · Dr. Stokley
Medicaid0113843MS
Medicare UPINF85485MS
Other009700450AL · Dr. Tynes
Other279588MS · Dr. Stokley
Other009926375AL · Dr. Strokley
Other073075294TYNAL · Dr. Tynes
Medicare UPINE87617MS
Medicaid0117444MS

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 of Waiver 25D0918730

Mississippi Family Medicine PC · Waynesboro, MS
Active · expires Jan 27, 2027
CLIA Number25D0918730
Laboratory TypePhysician Office
Certificate Effective DateJanuary 28, 2025
Certificate Expiration DateJanuary 27, 2027
Laboratory DirectorC Todd Stokley
Laboratory Phone(601) 671-8555
Laboratory LocationMississippi Family Medicine PC940 Matthew Drive Suite 2, Waynesboro, MS 39367
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

HATTIESBURG CLINIC PA
Internal Medicine (Cardiovascular Disease)
940 MATTHEW DR
WAYNESBORO, MS 39367
Wayne County (601) 735-7140
DR. SHELLEY BRAND D.P.M.
Podiatrist
940 MATTHEW DR
WAYNESBORO, MS 39367
Wayne County (601) 735-7243
PEYTON LOWERY ROGERS NP
Nurse Practitioner
940 MATTHEW DR, STE 2
WAYNESBORO, MS 39367
Wayne County (601) 671-8555
WAYNE GENERAL HOSPITAL
Clinic/Center
940 MATTHEW DR, SUITE 5
WAYNESBORO, MS 39367
Wayne County (601) 735-7285

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 Mississippi Family Medicine P C's NPI number?

The NPI number for Mississippi Family Medicine P C is 1669522942. It was assigned to this organization in the NPPES registry on January 11, 2007.

Where is Mississippi Family Medicine P C located?

Mississippi Family Medicine P C is located at 940 Matthew Dr Suite 2, Waynesboro, MS 39367. The listed phone number is (601) 671-8555.

What is Mississippi Family Medicine P C's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Mississippi Family Medicine P C hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D0918730) is associated with this NPI, valid through January 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Mississippi Family Medicine P C 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 Mississippi Family Medicine P C 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 Mississippi Family Medicine P C was last updated on July 20, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.