SPEARS MEDICAL CLINIC PLLC NPI 1003497751

NPI Information

NPI: 1003497751
Provider Name: SPEARS MEDICAL CLINIC PLLC
Classification: Nurse Practitioner - 363LF0000X
Specialization: Family
Entity Type: Organization
CLIA Number: 25D2228984
Address: 804 ROBB ST
SUMMIT, MS
ZIP 39666
Phone: (601) 608-0900

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NPI Details

SPEARS MEDICAL CLINIC PLLC is a family nurse practitioner in Summit, MS. SPEARS MEDICAL CLINIC PLLC NPI is 1003497751. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

804 ROBB ST
SUMMIT, MS
ZIP 39666-291
Phone: (601) 608-0900
Fax: (601) 600-2171

The provider's authorized official is Damon Scott Spears .
The authorized official title is Owner and has the following contact phone number (601) 600-6522.

The CLIA number assigned to this NPI record is 25D2228984 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/15/2021 and was last updated on 4/30/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	08751030	MEDICAID	MISSISSIPPI
2	1679628697	OTHER	MISSISSIPPI	NPPES NPI REGISTRY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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