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Grenada Lake Medical Center

Obstetrics & Gynecology Physician in Grenada, MS · enumerated 2006 · authorized official Shelley Smith, Clinical Director.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1669578894

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Registry record

Entity type Organization (Type 2)
Legal business name Grenada Lake Medical Center
Other name <Unavail>
Practice address 1900 Grandview Dr, Grenada, MS, 38901
Phone (662) 226-5121
Fax (662) 226-7529
Enumeration date Sep 15, 2006
Last updated in NPPES Apr 3, 2012

Taxonomy & classification

207V00000X Obstetrics & Gynecology Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Shelley Smith
Title Clinical Director
Phone (662) 226-5121

Other identifiers

Identifier Type State Issuer
07436578 Medicaid MS -

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.

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Frequently asked questions

What is the NPI number for Grenada Lake Medical Center?
The NPI for Grenada Lake Medical Center is 1669578894, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Grenada Lake Medical Center?
NPPES lists Shelley Smith (Clinical Director) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2012-04-03.