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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: August 09, 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 from Magnolia Health and more.Insurance ›

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.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAUREN P HILL LMSW
Social Worker
415 S 28TH AVE FL 1
HATTIESBURG, MS 39401
Forrest County (601) 288-5200
TAYLOR DAVIS FULKS DO
Family Medicine
415 S 28TH AVE FL 1
HATTIESBURG, MS 39401
Forrest County (601) 288-5200
EMILY GOFF DIXON LCSW
Social Worker
415 S 28TH AVE FL 1
HATTIESBURG, MS 39401
Forrest County (601) 579-3300
EMILY SCHALMO DO
Family Medicine
415 S 28TH AVE FL 1
HATTIESBURG, MS 39401
Forrest County (601) 288-5200

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.

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 from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, 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.