MEMPHIS CHILDREN'S CLINIC, PLLC
NPI 1790865616
Pediatrics in Southaven, MS

Active since October 16, 2006CLIA 25D0677021 · Certificate of Compliance
7672 AIRWAYS BLVD, SOUTHAVEN, MS 38671(662) 349-2555(662) 349-0700 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Memphis Children's Clinic, Pllc NPPES

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

MEMPHIS CHILDREN'S CLINIC, PLLC (NPI 1790865616) is a healthcare organization registered as a pediatrics in Southaven, Mississippi and active in the NPI registry since October 2006. The organization holds a CLIA Certificate of Compliance certificate valid through June 23, 2027 and lists Robert M Bertin, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1790865616
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameMEMPHIS CHILDREN'S CLINIC, PLLC
Location Address7672 AIRWAYS BLVDSouthaven, MS 38671-5304
Mailing Address1129 Hale RdMemphis, TN 38116-6373 · (901) 396-0390 · Fax (901) 396-3728
Fax(662) 349-0700
Organization SubpartNo
Authorized OfficialRobert M BertinPractice Manager · (901) 396-0390
Enumeration DateOctober 16, 2006
Last NPPES UpdateAugust 22, 2020
NPI 1790865616 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

7672 AIRWAYS BLVD, Southaven, MS 38671

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

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 Compliance 25D0677021

Memphis Childrens Clinic · Southaven, MS
Active · expires Jun 23, 2027
CLIA Number25D0677021
Laboratory TypePhysician Office
Certificate Effective DateJune 24, 2025
Certificate Expiration DateJune 23, 2027
Laboratory DirectorHarry Phillips
Laboratory Phone(662) 349-2555
Laboratory LocationMemphis Childrens Clinic7672 Airways, Southaven, MS 38671
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Memphis Children's Clinic, PLLC's NPI number?

The NPI number for Memphis Children's Clinic, PLLC is 1790865616. It was assigned to this organization in the NPPES registry on October 16, 2006.

Where is Memphis Children's Clinic, PLLC located?

Memphis Children's Clinic, PLLC is located at 7672 Airways Blvd, Southaven, MS 38671. The listed phone number is (662) 349-2555.

What is Memphis Children's Clinic, PLLC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Memphis Children's Clinic, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 25D0677021) is associated with this NPI, valid through June 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Memphis Children's Clinic, PLLC was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.