LAUDERDALE MEDICAL GROUP
NPI 1689456527
Clinic/Center - Primary Care in Pontotoc, MS
About Lauderdale Medical Group NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAUDERDALE MEDICAL GROUP (NPI 1689456527) is a healthcare organization registered as a primary care in Pontotoc, Mississippi and active in the NPI registry since October 2023. The organization holds a CLIA Waiver certificate valid through February 26, 2028 and lists Jessica Anne Lauderdale, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
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)
Lauderdale Medical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Lauderdale Medical Group, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 25D2299820
Lauderdale Medical Group PLLC · Pontotoc, 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 Lauderdale Medical Group PLLC's NPI number?
The NPI number for Lauderdale Medical Group PLLC is 1689456527. It was assigned to this organization in the NPPES registry on October 16, 2023. The provider is doing business as Lauderdale Medical Group.
Where is Lauderdale Medical Group PLLC located?
Lauderdale Medical Group PLLC is located at 11 E Jefferson St, Pontotoc, MS 38863. The listed phone number is (662) 419-1260.
What is Lauderdale Medical Group PLLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Lauderdale Medical Group PLLC enrolled in Medicare?
Yes. Lauderdale Medical Group PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Lauderdale Medical Group PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Lauderdale Medical Group PLLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Lauderdale Medical Group PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 25D2299820) is associated with this NPI, valid through February 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Lauderdale Medical Group PLLC accept?
Health plans from Molina Healthcare list Lauderdale Medical Group PLLC 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 Lauderdale Medical Group PLLC was last updated on March 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Lauderdale Medical Group · NPI 1689456527
Primary Care organization in Pontotoc, Mississippi. Organization record, active in the CMS NPPES registry since October 16, 2023.
## Identity
- **NPI:** 1689456527 (Entity type: Organization)
- **Enumerated:** October 16, 2023
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Legal business name:** Lauderdale Medical Group Pllc
- **Organization subpart:** No
- **Authorized official:** Jessica Lauderdale, OWNER
## Practice location
- **Address:** 11 E JEFFERSON ST, Pontotoc, MS 38863-2807
- **Phone:** (662) 419-1260
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 22, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1689456527) · Data from the CMS NPPES public registry.