PRIME CARE CLINIC OF CLINTON, LLC
NPI 1790444263
Nurse Practitioner - Adult Health in Clinton, MS

Active since December 13, 2021CLIA 25D2253545 · Waiver
709 CLINTON PKWY, CLINTON, MS 39056(601) 259-9532 Get Directions Write a Review

NPPES record last updated: January 25, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 25, 2022, Dec 13, 2021 (2 updates tracked since 2021).

About Prime Care Clinic Of Clinton, Llc NPPES

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

PRIME CARE CLINIC OF CLINTON, LLC (NPI 1790444263) is a healthcare organization registered as an adult health in Clinton, Mississippi and active in the NPI registry since December 2021. The organization holds a CLIA Waiver certificate valid through February 21, 2028 and lists Justin C Jackson, Member/coo, as its authorized official.

NPPES Registry Identity

NPI1790444263
Entity TypeOrganization
Primary Taxonomy363LA2200X
Legal Business NamePRIME CARE CLINIC OF CLINTON, LLC
Location Address709 CLINTON PKWYClinton, MS 39056-5245
Mailing AddressPo Box 785Clinton, MS 39060-0785 · (601) 519-7692
Organization SubpartNo
Authorized OfficialJustin C JacksonMember/coo · (601) 519-7692
Enumeration DateDecember 13, 2021
Last NPPES UpdateJanuary 25, 20222 updates tracked since enumeration
NPPES CertifiedJanuary 25, 2022
NPI 1790444263 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
709 CLINTON PKWY, Clinton, MS 39056

Other Identifiers 1

Medicaid1578049276MS

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted 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 25D2253545

Prime Care Clinic Of Clinton · Clinton, MS
Active · expires Feb 21, 2028
CLIA Number25D2253545
Laboratory TypePhysician Office
Certificate Effective DateFebruary 22, 2026
Certificate Expiration DateFebruary 21, 2028
Laboratory DirectorMelissa B. Jackson
Laboratory Phone(601) 259-9532
Laboratory LocationPrime Care Clinic Of Clinton709 Clinton Parkway, Clinton, MS 39056
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 Prime Care Clinic Of Clinton, LLC's NPI number?

The NPI number for Prime Care Clinic Of Clinton, LLC is 1790444263. It was assigned to this organization in the NPPES registry on December 13, 2021.

Where is Prime Care Clinic Of Clinton, LLC located?

Prime Care Clinic Of Clinton, LLC is located at 709 Clinton Pkwy, Clinton, MS 39056. The listed phone number is (601) 259-9532.

What is Prime Care Clinic Of Clinton, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Does Prime Care Clinic Of Clinton, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2253545) is associated with this NPI, valid through February 21, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Prime Care Clinic Of Clinton, LLC 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 and 1 other insurer list Prime Care Clinic Of Clinton, LLC 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 Prime Care Clinic Of Clinton, LLC was last updated on January 25, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.