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Export Provider Record NPI 1124505912
Thaxton Family Medical Clinic Llc
Organization Subpart: NO
Active
NPI Number1124505912
NPI TypeNPI-2 Organization
SpecialtyNurse Practitioner, Primary Care
Provider Details
NPI1124505912
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2018-07-24
Last Updated2018-07-24
Authorized OfficialKevin Floyd
provider/managing member
Phone: 6622137890
Mailing Address11145 Highway 6 W
Thaxton, MS 38871-9024
United States
Phone: (662) 489-8500 | Fax: (662) 489-8600
📍 View Map
Primary Practice Address11145 Highway 6 W
Thaxton, MS 38871-9024
United States
Phone: (662) 489-8500 | Fax: (662) 489-8600
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No261QP2300X – Clinic/Center, Primary CareMS901818
Yes363LP2300X – Nurse Practitioner, Primary CareMS901818
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About NPI 1124505912

Thaxton Family Medical Clinic Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1124505912. The primary specialty listed is Nurse Practitioner, Primary Care. The organization is located in Thaxton, MS. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2018-07-24. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1124505912?

NPI 1124505912 belongs to Thaxton Family Medical Clinic Llc, a Nurse Practitioner, Primary Care in Thaxton, MS. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1124505912 active?

The current status of NPI 1124505912 in the NPPES registry is Active. The record was last updated on 2018-07-24.

What specialty is NPI 1124505912?

NPI 1124505912 is classified under the taxonomy Nurse Practitioner, Primary Care. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1124505912?

You can verify NPI 1124505912 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1124505912?

The primary practice address on file for NPI 1124505912 is 11145 Highway 6 W, Thaxton, MS 38871-9024. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1124505912 issued?

NPI 1124505912 was first issued (enumerated) on 2018-07-24. The NPPES record was last updated on 2018-07-24.

Practice Location Map

Thaxton Family Medical Clinic Llc is located at 11145 Highway 6 W, Thaxton, MS. Use the map below to find directions or verify the practice location.

📍 11145 Highway 6 W, Thaxton, MS 38871-9024  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Thaxton Family Medical Clinic Llc. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1124505912. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Clinic/Center, Primary Care901818MS
Nurse Practitioner, Primary Care901818MS
Data Verified from CMS NPPES Last synced: 2026-06-30 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162