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LUCEDALE URGENT CARE, PC
NPI 1700372034
Clinic/Center - Multi-Specialty in Lucedale, MS

Active since July 10, 2018
103 W FRONTAGE RD STE C, LUCEDALE, MS 39452(251) 633-0123(251) 445-3722 Get Directions Write a Review

NPPES record last updated: June 6, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 6, 2023, Feb 16, 2023, Dec 6, 2022 and 1 more (4 updates tracked since 2018).

About Lucedale Urgent Care, Pc NPPES

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

LUCEDALE URGENT CARE, PC (NPI 1700372034) is a healthcare organization registered as a multi-specialty in Lucedale, Mississippi and active in the NPI registry since July 2018. The organization lists Bridgot Peters, Billing Director, as its authorized official.

NPPES Registry Identity

NPI1700372034
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameLUCEDALE URGENT CARE, PC
Location Address103 W FRONTAGE RD STE CLucedale, MS 39452-5836
Mailing Address103 W Frontage Rd Ste CLucedale, MS 39452-5836 · (601) 947-9596 · Fax (251) 445-3722
Phone(251) 633-0123
Fax(251) 445-3722
Organization SubpartNo
Authorized OfficialBridgot PetersBilling Director · (251) 445-7618
Enumeration DateJuly 10, 2018
Last NPPES UpdateJune 6, 20234 updates tracked since enumeration
NPPES CertifiedJune 6, 2023
✔ NPI 1700372034 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
Also ListedClinic/Center · Urgent CareTaxonomy 261QU0200X
103 W FRONTAGE RD STE C, Lucedale, MS 39452
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Other Names 1

Doing Business AsLucedale Urgent Care, Pc

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)

Lucedale Urgent Care, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Lucedale Urgent Care, PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Leigh Havens, NP
Nurse Practitioner
NPI 1437477163
103 W FRONTAGE RD STE C
Lucedale, MS 39452
(601) 947-9596
✔ PECOS✔ Accepts MedicareSame address
Tara Tillman, FNP
Nurse Practitioner
NPI 1245129030
103 W FRONTAGE RD
Lucedale, MS 39452
(601) 947-9596
✔ PECOSSame address
Hollis Ward, CRNP
Nurse Practitioner
NPI 1154341774
251 N BAYOU ST
Mobile, AL 36603
(251) 690-8158
✔ PECOS✔ Accepts Medicare36 mi
Jessica Gates, CRNP
Nurse Practitioner
NPI 1235653742
1 PERIMETER PARK S STE 195A
Birmingham, AL 35243
(866) 849-0692
✔ PECOS✔ Accepts Medicare206 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Lucedale Urgent Care, PC's NPI number?

The NPI number for Lucedale Urgent Care, PC is 1700372034. It was assigned to this organization in the NPPES registry on July 10, 2018.

Where is Lucedale Urgent Care, PC located?

Lucedale Urgent Care, PC is located at 103 W Frontage Rd Ste C, Lucedale, MS 39452. The listed phone number is (251) 633-0123.

What is Lucedale Urgent Care, PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Is Lucedale Urgent Care, PC enrolled in Medicare?

Yes. Lucedale Urgent Care, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lucedale Urgent Care, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Lucedale Urgent Care, PC. 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Lucedale Urgent Care, PC accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 3 other insurers list Lucedale Urgent Care, PC 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 Lucedale Urgent Care, PC was last updated on June 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.