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SOUTH RIDGE FAMILY CLINIC, LLC
NPI 1881930469
Family Medicine in Ellisville, MS

Active since December 31, 2012CLIA 25D2050591 · Waiver
80 HAL CROCKER RD, ELLISVILLE, MS 39437(601) 477-2221 Get Directions Write a Review

NPPES record last updated: December 31, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About South Ridge Family Clinic, Llc NPPES

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

SOUTH RIDGE FAMILY CLINIC, LLC (NPI 1881930469) is a healthcare organization registered as a family medicine in Ellisville, Mississippi and active in the NPI registry since December 2012. The organization holds a CLIA Waiver certificate valid through March 27, 2027 and lists Marlana Hedgepeth, Owner, as its authorized official.

NPPES Registry Identity

NPI1881930469
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSOUTH RIDGE FAMILY CLINIC, LLC
Location Address80 HAL CROCKER RDEllisville, MS 39437-2089
Mailing Address80 Hal Crocker RdEllisville, MS 39437-2089
Phone(601) 477-2221
Organization SubpartNo
Authorized OfficialMarlana HedgepethOwner · (601) 477-2221
Enumeration DateDecember 31, 2012
✔ NPI 1881930469 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.
80 HAL CROCKER RD, Ellisville, MS 39437
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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 25D2050591

South Ridge Family Clinic LLC · Ellisville, MS
Active · expires Mar 27, 2027
CLIA Number25D2050591
Laboratory TypePractitioner Other
Certificate Effective DateMarch 28, 2025
Certificate Expiration DateMarch 27, 2027
Laboratory DirectorMarlana P. Hedgepeth
Laboratory Phone(601) 477-2221
Laboratory LocationSouth Ridge Family Clinic LLC80 Hal Crocker Road, Ellisville, MS 39437
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 2

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

MARLANA PERKINS HEDGEPETH FNP
Nurse Practitioner
80 HAL CROCKER RD
ELLISVILLE, MS 39437
Jones County (601) 477-2221
DR. HOPE PERKINS DO
Family Medicine
80 HAL CROCKER RD
ELLISVILLE, MS 39437
Jones County (601) 477-2221

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 South Ridge Family Clinic, LLC's NPI number?

The NPI number for South Ridge Family Clinic, LLC is 1881930469. It was assigned to this organization in the NPPES registry on December 31, 2012.

Where is South Ridge Family Clinic, LLC located?

South Ridge Family Clinic, LLC is located at 80 Hal Crocker Rd, Ellisville, MS 39437. The listed phone number is (601) 477-2221.

What is South Ridge Family Clinic, LLC's specialty?

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

Does South Ridge Family Clinic, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2050591) is associated with this NPI, valid through March 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does South Ridge Family Clinic, 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 South Ridge Family Clinic, 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 South Ridge Family Clinic, LLC was last updated on December 31, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.