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PUCKETT FAMILY MEDICAL CLINIC
NPI 1689285249
Nurse Practitioner - Family in Brandon, MS

Active since August 16, 2020
6455 HIGHWAY 18, BRANDON, MS 39042(601) 824-9490(601) 824-5855 Get Directions Write a Review

NPPES record last updated: August 16, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Puckett Family Medical Clinic NPPES

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

PUCKETT FAMILY MEDICAL CLINIC (NPI 1689285249) is a healthcare organization registered as a family in Brandon, Mississippi and active in the NPI registry since August 2020. The organization lists Ashely M Shivers, Owner, as its authorized official.

NPPES Registry Identity

NPI1689285249
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NamePUCKETT FAMILY MEDICAL CLINIC
Location Address6455 HIGHWAY 18Brandon, MS 39042-7536
Mailing AddressPo Box 580Puckett, MS 39151-0580 · (601) 824-9490 · Fax (601) 824-5855
Phone(601) 824-9490
Fax(601) 824-5855
Organization SubpartNo
Authorized OfficialAshely M ShiversOwner · (601) 824-9490
Enumeration DateAugust 16, 2020
NPPES CertifiedAugust 16, 2020
✔ NPI 1689285249 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
6455 HIGHWAY 18, Brandon, MS 39042
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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 SINGLE SPECIALTY GROUP

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.

SIMPSON COMMUNITY HEALTHCARE, INC
Clinic/Center (Rural Health)
6455 HIGHWAY 18
BRANDON, MS 39042
Rankin County (601) 824-9490
PUCKETT MEDICAL CLINIC
Clinic/Center (Health Service)
6455 HIGHWAY 18
BRANDON, MS 39042
Rankin County (601) 824-9490

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 Puckett Family Medical Clinic's NPI number?

The NPI number for Puckett Family Medical Clinic is 1689285249. It was assigned to this organization in the NPPES registry on August 16, 2020.

Where is Puckett Family Medical Clinic located?

Puckett Family Medical Clinic is located at 6455 Highway 18, Brandon, MS 39042. The listed phone number is (601) 824-9490.

What is Puckett Family Medical Clinic's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Puckett Family Medical Clinic was last updated on August 16, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.