STATCARE PLLC
NPI 1174579338
Clinic/Center in Mccomb, MS
NPI Status: Active since May 26, 2006
Contact Information
1017 DELAWARE AVE
MCCOMB, MS
ZIP 39648
Phone: (601) 250-1122
Fax: (601) 250-0290
- Organization
- Clinic/Center
- Accepts Insurance
- CLIA Number: 25D2142182
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-03-2026
About STATCARE PLLC
This page provides the complete NPI Profile along with additional information for Statcare Pllc, a provider established in Mccomb, Mississippi operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1174579338 assigned on May 2006. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated 18 years ago. The authorized official of this NPI record is Debra B Kennedy (Office Manager)
- NPI
- 1174579338
- Provider Name
- STATCARE PLLC
- Entity Type
- Organization
- Location Address
- 1017 DELAWARE AVE MCCOMB, MS 39648
- Location Phone
- (601) 250-1122
- Location Fax
- (601) 250-0290
- Mailing Address
- PO BOX 1909 MCCOMB, MS 39649
- Mailing Phone
- (601) 250-1122
- Mailing Fax
- (601) 250-0290
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-26-2006
- Last Update Date
- 10-23-2007
- Code Navigator
Location Map
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
- Taxonomy Code
- 261Q00000X
- Type
- Ambulatory Health Care Facilities
- Taxonomy Description
- A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA (QualChoice) - POS
- Complete Gold - PPO
- Complete Gold + Vision + Adult Dental - PPO
- Complete Silver (QualChoice) - POS
- Connected Silver - PPO
- Connected Silver (QualChoice) - POS
- Connected Silver (QualChoiceLife) - PPO
- Connected Silver + Vision + Adult Dental - PPO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Clear Silver - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Bronze 4 - HMO
- Bronze 8 - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| CN2774 | OTHER (01) | MS | MEDICARE RAILROAD |
| C02326 | MEDICARE ID-TYPE UNSPECIFIED (04) | MS |
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
- 25D2142182
- Facility Type
- Physician Office
- Certificate Effective Date
- January 04, 2024
- Certificate Expiration Date
- January 03, 2026
- Laboratory Director
- JOHN A. WATSON
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Statcare Pllc 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.
Reviews for STATCARE PLLC
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 7 | 4 | 5 | 7 | 9 | 3 | 3 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 14 | 4 | 10 | 7 | 18 | 3 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 4 + 4 + 1 + 0 + 7 + 1 + 8 + 3 + 6 + 24 = 62 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 62 = 8 | 8 | ||||||||
The NPI number 1174579338 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 6 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1851370795 | DR. JOHN ANDREW WATSON D.O. Individual | Emergency Medicine | 1017 DELAWARE AVE MCCOMB, MS 39648 (601) 250-1122 |
| 1730168618 | MR. DARRYL TEMPLE FNP Individual | Emergency Medicine | 1017 DELAWARE AVE MCCOMB, MS 39648 (601) 250-1122 |
| 1568473270 | JACKIE EUGENE BRISTER F.N.P. Individual | Nurse Practitioner (Family) | 1017 DELAWARE AVE MCCOMB, MS 39648 (601) 250-1122 |
| 1629057427 | DR. SCOTT FARR SMITH M.D. Individual | Emergency Medicine | 1017 DELAWARE AVE MCCOMB, MS 39648 (601) 250-1122 |
| 1699754572 | DR. BRETT BIENVILLE TISDALE M.D. Individual | Emergency Medicine | 1017 DELAWARE AVE MCCOMB, MS 39648 (601) 250-1122 |
| 1578084521 | CHRISTOPHER HARVEY BRACEY FNP Individual | Family Medicine | 1017 DELAWARE AVE MCCOMB, MS 39648 (601) 250-1122 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174579338, enumerated in the NPI registry as an "organization" on May 26, 2006
The provider is located at 1017 Delaware Ave Mccomb, Ms 39648 and the phone number is (601) 250-1122
This medical organization specializes in Clinic/Center with taxonomy code 261Q00000X
The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 25D2142182 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued 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..
This NPI record was last updated on May 26, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.