SOUTHERN ROOTS FAMILY CARE
NPI 1891487070
Clinic/Center - Primary Care in Troup, TX
About Southern Roots Family Care NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHERN ROOTS FAMILY CARE (NPI 1891487070) is a healthcare organization registered as a primary care in Troup, Texas and active in the NPI registry since May 2023. The organization holds a CLIA Waiver certificate valid through January 29, 2028 and lists Stephanie Mcclure, Fnp-c, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southern Roots Family Care is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Southern Roots Family Care, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 45D2298147
Southern Roots Family Care · Troup, TXFrequently 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 Southern Roots Family Care's NPI number?
The NPI number for Southern Roots Family Care is 1891487070. It was assigned to this organization in the NPPES registry on May 24, 2023.
Where is Southern Roots Family Care located?
Southern Roots Family Care is located at 400 W. Calvert St , Unit C, Troup, TX 75789. The listed phone number is (903) 969-5056.
What is Southern Roots Family Care's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Southern Roots Family Care enrolled in Medicare?
Yes. Southern Roots Family Care is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southern Roots Family Care?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Southern Roots Family Care. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Southern Roots Family Care hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 45D2298147) is associated with this NPI, valid through January 29, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Southern Roots Family Care was last updated on April 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.
# Southern Roots Family Care · NPI 1891487070
Primary Care organization in Troup, Texas. Organization record, active in the CMS NPPES registry since May 24, 2023.
## Identity
- **NPI:** 1891487070 (Entity type: Organization)
- **Enumerated:** May 24, 2023
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Also known as:** Southern Roots Family Care (Doing Business As)
- **Organization subpart:** Yes (part of Mcclure Healthcare, Pllc)
- **Authorized official:** Stephanie Mcclure, FNP-C
## Practice location
- **Address:** 400 W. CALVERT ST , UNIT C, Troup, TX 75789
- **Phone:** (903) 969-5056
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 21, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1891487070) · Data from the CMS NPPES public registry.