Family Medical Clinic of Crystal Springs PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FAMILY MEDICAL CLINIC OF CRYSTAL SPRINGS PLLC

Practice address

104 W Railroad Ave S
Crystal Springs, MS 39059-2111

Phone

(601) 892-3063

Fax

(601) 892-3570

NPI assigned

Nov 3, 2006

Last updated

Nov 18, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. James W Ervin, M.D.NPI 1619903580

Title

President

Phone

(601) 892-3063

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• James Wilfred Ervin Jr., M.D.

  • Family Medicine Physician
  • Crystal Springs, MS
  • NPI 1619903580
  Medicare reassignment Care Compare group NPD Authorized official
• Jenna Gaddy

  • Nurse Practitioner
  • Crystal Springs, MS
  • NPI 1114470143
  Medicare reassignment Care Compare group NPD
• Jennifer Mach Sojourner, CFNP

  • Family Nurse Practitioner
  • Crystal Springs, MS
  • NPI 1679881312
  Medicare reassignment Care Compare group NPD
• Mary Kamryn Brewer, FNP-C

  • Family Nurse Practitioner
  • Madison, MS
  • NPI 1255943932
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763424000000",
    "number": "1205915998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W RAILROAD AVE S",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390592111",
            "telephone_number": "601-892-3063",
            "fax_number": "601-892-3570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W RAILROAD AVE S",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390592111",
            "telephone_number": "601-892-3063",
            "fax_number": "601-892-3570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL CLINIC OF CRYSTAL SPRINGS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A",
        "authorized_official_last_name": "ERVIN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-892-3063",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06726832",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal Springs Dental Center, LLC
• Drayer Physical Therapy Mississippi LLC
• Emanuel Unlimited
• Enduracare Acute Care Services LLC
• James Wilfred Ervin Jr., M.D.
• First Care (shirley smith)
• Freedom Prosthetics Ms LLC
• Jenna Gaddy
• Robert A. Gannaway, M.D.
• Guardian Care LLC.

• Family Medicine Physician in Crystal Springs, MS
• Providers in Crystal Springs, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.