PUCKETT MEDICAL CLINIC
NPI 1932476280
Clinic/Center - Health Service in Brandon, MS

NPI Status: Active since November 30, 2011

Contact Information

6455 HIGHWAY 18
BRANDON, MS
ZIP 39042
Phone: (601) 824-9490
Fax: (601) 824-9533

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  • Organization
  • Clinic/Center
  • Health Service
  • CLIA Number: 25D1099500
  • CLIA Cert. Type: Rural Health Clinic
  • CLIA Exp. Date: 05-13-2027

About PUCKETT MEDICAL CLINIC

This page provides the complete NPI Profile along with additional information for Puckett Medical Clinic, a provider established in Brandon, Mississippi operating as a Clinic/center, focusing in health service . The healthcare provider is registered in the NPI registry with number 1932476280 assigned on November 2011. The practitioner's primary taxonomy code is 261QH0100X with license number R633283 (MS). The provider is registered as an organization and their NPI record was last updated 15 years ago. The authorized official of this NPI record is Debra Develin Cfnp (Owner)

NPI
1932476280
Provider Name
PUCKETT MEDICAL CLINIC
Entity Type
Organization
Location Address
6455 HIGHWAY 18 BRANDON, MS 39042
Location Phone
(601) 824-9490
Location Fax
(601) 824-9533
Mailing Address
PO BOX 366 PUCKETT, MS 39151
Mailing Phone
(601) 824-9490
Mailing Fax
(601) 824-9533
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-30-2011
Last Update Date
11-30-2011
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Health Service

Taxonomy Code
261QH0100X
Type
Ambulatory Health Care Facilities
License No.
R633283
License State
MS

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DEBRA DEVELIN CFNP

Authorized Official Title
OWNER
Authorized Official Phone
(601) 824-9490

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
25D1099500
Facility Type
Rural Health Clinic
Certificate Effective Date
May 14, 2025
Certificate Expiration Date
May 13, 2027
Laboratory Director
HARPAL SINGH
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Puckett Medical Clinic to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1932476280, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 70. The final step is to find the difference between that total and the next multiple of ten (70 - 70 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
9
Unchanged
Pos 3
3
Doubled → 6
Pos 4
2
Unchanged
Pos 5
4
Doubled → 8
Pos 6
7
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
2
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 4 → 8 6 → 12 → 3 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 9 + 6 + 2 + 8 + 7 + 1 + 2 + 2 + 1 + 6 + 24 = 70

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 70 is 70. The difference is the calculated check digit.

70 - 70 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1932476280.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Clinic/Center (Rural Health)
6455 HIGHWAY 18
BRANDON, MS 39042
Nurse Practitioner (Family)
6455 HIGHWAY 18
BRANDON, MS 39042

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1932476280, enumerated as an "organization" on November 30, 2011.

The provider is located at 6455 HIGHWAY 18 BRANDON, MS 39042 and the phone number is (601) 824-9490.

Clinic/Center with taxonomy code 261QH0100X and a focus in Health Service.