Caledonia Community Clinic, LLC
NPI 1619552130 · Family Medicine Physician · Caledonia, MS
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Caledonia Community Clinic, LLC is a Family Medicine Physician organization in Caledonia, MS (NPI 1619552130).
Provider details
- NPI number
- 1619552130
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Lisa Hudson, Fnp-C(662) 251-3451
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2021-03-16
- Last updated
- 2021-03-16
- Certified
- 2021-03-16
Frequently asked questions
- What is Caledonia Community Clinic, LLC's NPI number?
- Caledonia Community Clinic, LLC's National Provider Identifier (NPI) is 1619552130, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Caledonia Community Clinic, LLC?
- Caledonia Community Clinic, LLC is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Caledonia Community Clinic, LLC located?
- Caledonia Community Clinic, LLC's practice location on file with NPPES is 171 South St, Caledonia, MS 39740-8587.
- What is Caledonia Community Clinic, LLC's phone number?
- The practice phone number listed in the NPPES registry for Caledonia Community Clinic, LLC is (662) 855-0080.
- Does Caledonia Community Clinic, LLC accept Medicare?
- Caledonia Community Clinic, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Caledonia Community Clinic, LLC?
- The authorized official listed on Caledonia Community Clinic, LLC's NPPES record is Lisa Hudson, Fnp-C. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Caledonia Community Clinic, LLC's NPI active?
- Yes — Caledonia Community Clinic, LLC's NPI (1619552130) is active in the NPPES registry as of the last update on 2021-03-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.