PUCKETT FAMILY MEDICAL CLINIC
NPI 1689285249
Nurse Practitioner - Family in Brandon, MS
NPI Status: Active since August 16, 2020
Contact Information
6455 HIGHWAY 18
BRANDON, MS
ZIP 39042
Phone: (601) 824-9490
Fax: (601) 824-5855
- Organization
- Nurse Practitioner
- Family
- CLIA Number: 25D1099500
- CLIA Cert. Type: Rural Health Clinic
- CLIA Exp. Date: 05-13-2027
About PUCKETT FAMILY MEDICAL CLINIC
This page provides the complete NPI Profile along with additional information for Puckett Family Medical Clinic, a provider established in Brandon, Mississippi operating as a Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1689285249 assigned on August 2020. The practitioner's primary taxonomy code is 363LF0000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Ashely M Shivers Np (Owner)
- NPI
- 1689285249
- Provider Name
- PUCKETT FAMILY MEDICAL CLINIC
- Entity Type
- Organization
- Location Address
- 6455 HIGHWAY 18 BRANDON, MS 39042
- Location Phone
- (601) 824-9490
- Location Fax
- (601) 824-5855
- Mailing Address
- PO BOX 580 PUCKETT, MS 39151
- Mailing Phone
- (601) 824-9490
- Mailing Fax
- (601) 824-5855
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-16-2020
- Last Update Date
- 08-16-2020
- Code Navigator
A nurse practitioner (NP) like Puckett Family Medical Clinic is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Family
- Taxonomy Code
- 363LF0000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 25D1099500
- Facility Type
- Rural Health Clinic
- Certificate Effective Date
- May 14, 2025
- Certificate Expiration Date
- May 13, 2027
- Laboratory Director
- HARPAL SINGH
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Puckett Family Medical Clinic to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1689285249, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 71. The final step is to find the difference between that total and the next multiple of ten (80 - 71 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 71 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1689285249, enumerated as an "organization" on August 16, 2020.
The provider is located at 6455 HIGHWAY 18 BRANDON, MS 39042 and the phone number is (601) 824-9490.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
