Statcare Pllc

Statcare Pllc is a healthcare organization registered as Clinic/Center in Mccomb, MS, holding Type 2 (organization) NPI 1174579338 since 2006. The authorized official on file is Debra Kennedy, Office Manager.

✓ Active NPI ✓ Valid NPI checksum

NPI	1174579338
Entity type	Organization (Type 2)
Legal business name	Statcare Pllc
Practice address	1017 DELAWARE AVE, Mccomb, MS, 39648
Phone	6012501122
Fax	6012500290
Enumeration date	2006-05-26
Last updated in NPPES	2007-10-23

Authorized official

Name	Debra Kennedy
Title	Office Manager
Phone	6012501122

Taxonomy & classification

Taxonomy code	Specialty	Primary	License	State
261Q00000X	Clinic/Center	Primary	—	—

Other identifiers

Identifier	Type	State	Issuer
CN2774	Other	MS	MEDICARE RAILROAD

Copy-ready billing details

Provider: Statcare Pllc
NPI: 1174579338
Taxonomy: 261Q00000X (Clinic/Center)
Address: 1017 DELAWARE AVE, Mccomb, MS, 39648

Providers at this address

NPI	Name	Type	Specialty	Location
1851370795	John Watson	Individual	Emergency Medicine Physician	Mccomb, MS
1699754572	Brett Tisdale	Individual	Emergency Medicine Physician	Mccomb, MS
1730168618	Darryl Temple	Individual	Emergency Medicine Physician	Mccomb, MS
1629057427	Scott Smith	Individual	Emergency Medicine Physician	Mccomb, MS
1568473270	Jackie Brister	Individual	Family Nurse Practitioner	Mccomb, MS

Verify this record

Cross-check NPI 1174579338 against the authoritative CMS record: view Statcare Pllc on the official NPPES registry .

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.

Frequently asked questions

Where is Statcare Pllc located?

The practice location on file with NPPES is in Mccomb, MS.

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2007-10-23. Verify at npiregistry.cms.hhs.gov.

Source: CMS NPPES (public data). Snapshot 2026-07-10. Provider record last updated 2007-10-23.