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FAMILY MEDICINE RESIDENCY CLINIC
NPI 1699267625
Family Medicine in Hattiesburg, MS

Active since June 05, 2018CLIA 25D2150882 · Waiver
415 S 28TH AVE FL 1, HATTIESBURG, MS 39401(601) 579-3300(601) 268-5738 Get Directions Write a Review

NPPES record last updated: June 5, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Family Medicine Residency Clinic NPPES

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

FAMILY MEDICINE RESIDENCY CLINIC (NPI 1699267625) is a healthcare organization registered as a family medicine in Hattiesburg, Mississippi and active in the NPI registry since June 2018. The organization holds a CLIA Waiver certificate valid through July 5, 2028 and lists David Pylate, Patient Accounts Manager, as its authorized official.

NPPES Registry Identity

NPI1699267625
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameFORREST COUNTY GENERAL HOSPITAL
Location Address415 S 28TH AVE FL 1Hattiesburg, MS 39401-7246
Mailing AddressPo Box 15722Hattiesburg, MS 39404-5722 · (601) 288-1823 · Fax (601) 288-1877
Phone(601) 579-3300
Fax(601) 268-5738
Organization SubpartNo
Authorized OfficialDavid PylatePatient Accounts Manager · (601) 288-1864
Enumeration DateJune 5, 2018
✔ NPI 1699267625 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
415 S 28TH AVE FL 1, Hattiesburg, MS 39401
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Other Names 1

Doing Business AsFamily Medicine Residency Clinic

Other Identifiers 1

Other6012Ssi Group

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

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 Health and more.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)

Family Medicine Residency Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

247

Medicare enrollment records show 247 clinicians reassign Medicare billing to Family Medicine Residency Clinic, which bills Medicare for the services they deliver. Of these, 34 practice at this address and 105 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 27

Nurse Practitioner69
Family Practice31
Neurology26
Psychiatry25
Internal Medicine17
Hospitalist10
Interventional Cardiology9
Cardiovascular Disease (Cardiology)8
19 other specialties52

Nearest to this location (20)

See all 247
Edward Askew, MD
Hospitalist
NPI 1619991809
415 S 28TH AVE
Hattiesburg, MS 39401
(601) 288-4329
✔ PECOSSame address
George Blair, MD
Interventional Cardiology
NPI 1902835234
415 S 28TH AVE
Hattiesburg, MS 39401
(601) 268-5800
✔ PECOS✔ Accepts MedicareSame address
Richard Clatterbuck, M.D.
Neurosurgery
NPI 1205887338
415 S 28TH AVE
Hattiesburg, MS 39401
(601) 579-5459
✔ PECOS✔ Accepts MedicareSame address
Patrick Dauphin, MD
Cardiovascular Disease (Cardiology)
NPI 1962866004
415 S 28TH AVE
Hattiesburg, MS 39401
(601) 264-6000
✔ PECOS✔ Accepts MedicareSame address
Christopher Douglas, M.D.
Interventional Cardiology
NPI 1427251511
415 S 28TH AVE
Hattiesburg, MS 39401
(601) 268-5800
✔ PECOS✔ Accepts MedicareSame address
Eric Enger, MD
Interventional Cardiology
NPI 1265442594
415 S 28TH AVE
Hattiesburg, MS 39401
(601) 268-5800
✔ PECOS✔ Accepts MedicareSame address
Taylor Fulks, DO
Family Practice
NPI 1295300085
415 S 28TH AVE FL 1
Hattiesburg, MS 39401
(601) 288-5200
✔ PECOS✔ Accepts MedicareSame address
Thomas Hale, MD
Family Practice
NPI 1790797389
415 S 28TH AVE
Hattiesburg, MS 39401
(601) 268-3300
✔ PECOS✔ Accepts MedicareSame address
Catherine Hulsey, M.D.
Hospitalist
NPI 1164483814
415 S 28TH AVE
Hattiesburg, MS 39401
(601) 288-4329
✔ PECOS✔ Accepts MedicareSame address
Frank Hux, DO
Neurosurgery
NPI 1003030578
415 S 28TH AVE
Hattiesburg, MS 39401
(601) 579-5459
✔ PECOS✔ Accepts MedicareSame address
Antonio Jaime Imperial, M.D.
Hospitalist
NPI 1902867021
415 S 28TH AVE
Hattiesburg, MS 39401
(601) 288-4329
✔ PECOS✔ Accepts MedicareSame address
Lawrence Leader, DO
Cardiovascular Disease (Cardiology)
NPI 1508970211
415 S 28TH AVE
Hattiesburg, MS 39401
(601) 268-5800
✔ PECOS✔ Accepts MedicareSame address
Brandi Lockley, FNP, RNFA
Nurse Practitioner
NPI 1457641276
415 S 28TH AVE
Hattiesburg, MS 39401
(601) 579-5459
✔ PECOS✔ Accepts MedicareSame address
Wissam Mechleb, MD
Cardiovascular Disease (Cardiology)
NPI 1487841847
415 S 28TH AVE
Hattiesburg, MS 39401
(601) 268-5800
✔ PECOS✔ Accepts MedicareSame address
Carlee Nicholson, DNP, FNP-BC
Nurse Practitioner
NPI 1508623570
415 S 28TH AVE
Hattiesburg, MS 39401
(601) 288-5200
✔ PECOS✔ Accepts MedicareSame address
Nathaniel Nowacki, M.D.
Neurology
NPI 1508201872
415 S 28TH AVE
Hattiesburg, MS 39401
(601) 288-4329
✔ PECOS✔ Accepts MedicareSame address
Robert Robbins, MD
Cardiac Surgery
NPI 1780792945
415 S 28TH AVE
Hattiesburg, MS 39401
(601) 268-5800
✔ PECOS✔ Accepts MedicareSame address
Kaitlen Schexnayder, M.D.
Urology
NPI 1518386788
415 S 28TH AVE
Hattiesburg, MS 39401
(601) 268-5888
✔ PECOS✔ Accepts MedicareSame address
L. Aldred, M.D.
Pulmonary Disease
NPI 1720428121
415 S 28TH AVE
Hattiesburg, MS 39401
(601) 268-5650
✔ PECOS✔ Accepts MedicareSame address
Christopher Hinson, D.O.
Internal Medicine
NPI 1952780066
415 S 28TH AVE
Hattiesburg, MS 39401
(601) 268-5800
✔ PECOS✔ Accepts MedicareSame address
See all 247 clinicians

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 25D2150882

Family Medicine Residency Clinic · Hattiesburg, MS
Active · expires Jul 5, 2028
CLIA Number25D2150882
Laboratory TypePhysician Office
Certificate Effective DateJuly 6, 2026
Certificate Expiration DateJuly 5, 2028
Laboratory DirectorDr. Eric T. Hale
Laboratory Phone(601) 579-3300
Laboratory LocationFamily Medicine Residency Clinic415 S 28th Avenue, Hattiesburg, MS 39401
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Forrest County General Hospital's NPI number?

The NPI number for Forrest County General Hospital is 1699267625. It was assigned to this organization in the NPPES registry on June 5, 2018. The provider is doing business as Family Medicine Residency Clinic.

Where is Forrest County General Hospital located?

Forrest County General Hospital is located at 415 S 28th Ave Fl 1, Hattiesburg, MS 39401. The listed phone number is (601) 579-3300.

What is Forrest County General Hospital's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Forrest County General Hospital enrolled in Medicare?

Yes. Forrest County General Hospital is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Forrest County General Hospital?

According to the CMS Revalidation Reassignment List (October 2026 release), 247 clinicians in 27 Medicare specialties reassign their Medicare billing to Forrest County General Hospital. 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. The largest specialties are Nurse Practitioner (69), Family Practice (31) and Neurology (26). Of these, 34 practice at this address and 105 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Forrest County General Hospital hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2150882) is associated with this NPI, valid through July 5, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Forrest County General Hospital accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee list Forrest County General Hospital 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 Forrest County General Hospital was last updated on June 5, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.