DRG FAYETTE PLLC — NPI 1891978953 (Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center in FAYETTE, MS)

CMS-1500 Box 24J / 33a • NPI

1891978953

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

261QE0700X (CMS B4[14])

Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center

Box 32 Service Location & ZIP+4

225 COMMUNITY DRIVE, OFF HWY 61, FAYETTE, MS, 39069

Official NPPES Practice Location

Practice Phone & Referral Fax

(601) 786-6676

Fax: (601) 786-6678

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1891978953 (DRG FAYETTE PLLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1891978953` (NPI-2 Organization / Facility)
Provider / Legal Name	DRG FAYETTE PLLC
Plain-English Specialty	Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: `261QE0700X` (Clinic/Center, End-Stage Renal Disease (ESRD) Treatment)
Certifying / Licensing Body	Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Practice Location Address	225 COMMUNITY DRIVE, OFF HWY 61, FAYETTE, MS, 39069
Practice Telephone / Fax	Tel: (601) 786-6676 \| Fax: (601) 786-6678
Administrative Mailing Address	5903 RIDGEWOOD RD, JACKSON, MS, 39211-3700
Enumeration & Last Sync	Enumerated: 2007-12-12 \| CMS Record Updated: 2008-01-15
Authorized Official	TUNDE OLUTADE (Member)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

225 COMMUNITY DRIVE, OFF HWY 61, FAYETTE, MS, 39069

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Plain-English Taxonomy & CMS Crosswalk (261QE0700X)

What Does Taxonomy Code 261QE0700X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261QE0700X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"

CMS-1500 Medicare Specialty Crosswalk: CMS Code B4[14] (End-Stage Renal Disease Facility)
Certifying / Accrediting Authority: Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Clinical Scope: Same-day outpatient consultations, urgent walk-in medical care, vaccinations, and day-case diagnostic procedures.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (DRG FAYETTE PLLC)

Typical CPT / Diagnostic Procedures:

Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures

Common Therapeutic Classes:

Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`261QE0700X` — Clinic/Center, End-Stage Renal Disease (ESRD) Treatment Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: MS \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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DRG FAYETTE PLLC (NPI #1891978953)