POTTS CAMP FAMILY MEDICAL CLINIC
NPI 1942519517
Nurse Practitioner - Family in Potts Camp, MS
About Potts Camp Family Medical Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
POTTS CAMP FAMILY MEDICAL CLINIC (NPI 1942519517) is a healthcare organization registered as a family in Potts Camp, Mississippi and active in the NPI registry since September 2010. The organization holds a CLIA Certificate of Compliance certificate valid through September 13, 2027 and lists Alice Stine, Business Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Potts Camp Family Medical Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Potts Camp Family Medical Clinic, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
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 Compliance 25D2014439
Potts Camp Family Medical Clinic · Potts Camp, MSFrequently 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 Potts Camp Family Medical Clinic's NPI number?
The NPI number for Potts Camp Family Medical Clinic is 1942519517. It was assigned to this organization in the NPPES registry on September 30, 2010.
Where is Potts Camp Family Medical Clinic located?
Potts Camp Family Medical Clinic is located at 3 Reids Alley, Potts Camp, MS 38659. The listed phone number is (662) 333-4333.
What is Potts Camp Family Medical Clinic's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Potts Camp Family Medical Clinic enrolled in Medicare?
Yes. Potts Camp Family Medical Clinic is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Potts Camp Family Medical Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Potts Camp Family Medical Clinic. 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Potts Camp Family Medical Clinic hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 25D2014439) is associated with this NPI, valid through September 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Potts Camp Family Medical Clinic accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 1 other insurer list Potts Camp Family Medical Clinic 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 Potts Camp Family Medical Clinic was last updated on September 30, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Potts Camp Family Medical Clinic · NPI 1942519517
Family organization in Potts Camp, Mississippi. Organization record, active in the CMS NPPES registry since September 30, 2010.
## Identity
- **NPI:** 1942519517 (Entity type: Organization)
- **Enumerated:** September 30, 2010
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Alice Stine, BUSINESS MANAGER
## Practice location
- **Address:** 3 REIDS ALLEY, Potts Camp, MS 38659
- **Phone:** (662) 333-4333
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 30, 2010
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1942519517) · Data from the CMS NPPES public registry.