Batesville Medical Clinic, LLC
Organization Active NPI Family Medicine Physician · Batesville, MS
NPI 1164077525 · NPPES record last updated May 26, 2026
Key facts
- NPI
- 1164077525
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- BATESVILLE MEDICAL CLINIC, LLC
- Practice address
- 107 Eureka St Ste a
Batesville, MS 38606-2533 - Phone
- (662) 563-6000
- Fax
- (662) 563-2200
- NPI assigned
- Aug 2, 2019
- Organization subpart
- No
Authorized official
- Name
- Dr. Michael R Havens, MD
- Title
- Medical Director/Owner
- Phone
- (662) 563-6000
Practitioners 6
-
Pamela Calvert, FNP-C
-
Michael Randolph Havens, M.D.
-
Brittany Leigh Wiggins, FNP-BC
-
Hannah Waldrip Devazier, AGPCNP-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 25D0316334 | Ummc Batesville Family Medicine Clinic | Certificate of waiver | Nov 30, 2027 |
| 25D2171101 | Batesville Medical Clinic, LLC | Certificate of waiver | Aug 25, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190921000059 | MS | Part B Supplier - Clinic/Group Practice | 6305176132 |
Receives reassigned benefits from 6 practitioners Practice locations: Batesville, MS |
National Provider Directory
Locations
107 Eureka St
#A
Batesville, MS 38606
Phone (662) 561-0800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
107 Eureka St Ste a
Batesville, MS 38606-2533
Mailing address
PO Box 395
Batesville, MS 38606-0395
Phone (662) 563-6000
Other practice location 1
255 Medical Center Dr
Batesville, MS 38606-8629
Phone (662) 563-6000
Other providers in Batesville, MS
- Batesville Hma Medical Group, LLC
- Batesville Hma Medical Group, LLC
- Batesville Hospital Management
- Batesville Hospital Management Inc
- Batesville Hospital Management, Inc.
- Batesville Pediatric Plus
- Batesville Premier Dental PLLC
- Batesville Regional Medical Center, Inc.
- Batesville Regional Medical Center, Inc.
- Batesville Regional Medical Center, Inc.
All providers in Batesville, MS · Family Medicine Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 26, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.