MISSISSIPPI FAMILY MEDICINE P C
NPI 1669522942
Clinic/Center - Primary Care in Waynesboro, MS
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
Specialties & Licenses
Other Identifiers 14
Accepted Insurance
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)
Mississippi Family Medicine P C is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
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
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Mississippi Family Medicine P C, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (3)
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 Waiver 25D0918730
Mississippi Family Medicine PC · Waynesboro, 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 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.
Is Mississippi Family Medicine P C enrolled in Medicare?
Yes. Mississippi Family Medicine P C is registered in the Medicare PECOS enrollment system.
When is Mississippi Family Medicine P C'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 December 31, 2026. 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 Mississippi Family Medicine P C?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Mississippi Family Medicine P C, 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 at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, 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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Mississippi Family Medicine P C · NPI 1669522942
Primary Care organization in Waynesboro, Mississippi. Organization record, active in the CMS NPPES registry since January 11, 2007.
## Identity
- **NPI:** 1669522942 (Entity type: Organization)
- **Enumerated:** January 11, 2007
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Barbara Dearman, INSURANCE CLERK
## Practice location
- **Address:** 940 MATTHEW DR, SUITE 2, Waynesboro, MS 39367-2522
- **Phone:** (601) 671-8555 · **Fax:** (601) 671-0777
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Mississippi, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 3 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (2), Family Practice (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 20, 2010
- **Other identifiers:** Other CD1005; Other 279588 (MS); Medicare ID-Type Unspecified 080002402 (MS); and 11 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1669522942) · Data from the CMS NPPES public registry.