SOUTH MISSISSIPPI REGIONAL CENTER (NPI# 1033143284) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033143284 |
| Entity Type | Organization |
| Organization Name | SOUTH MISSISSIPPI REGIONAL CENTER |
| Practice Address |
1170 W Railroad St Long Beach MS 39560-4106 |
| Practice Telephone | 2288671300 |
| Practice Fax Number | 2282145563 |
| Mailing Telephone | 2288671300 |
| Mailing Fax Number | 2282145563 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | PAMELA BAKER (DIRECTOR OF FACILITY) |
| Authorized Official Telephone | 2288671300 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 311 | MS | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00095206 | 05 | |
| MS | 09015481 | 05 | |
| MS | 09555710 | 05 | |
| MS | 00021842 | 05 | |
| MS | 00770072 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629392774 | South Mississippi Regional Center | Clinic/Center | 1170 W Railroad St, Long Beach, MS 39560-4106 | 2010-03-18 |
| 1578885117 | South Mississippi Regional Center | Intermediate Care Facility, Mentally Retarded | 1170 W Railroad St, Long Beach, MS 39560-4106 | 2010-02-24 |
| Street Address |
1170 W RAILROAD ST |
| City | LONG BEACH |
| State | MS |
| Zip Code | 39560-4106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629392774 | South Mississippi Regional Center | Clinic/Center | 1170 W Railroad St, Long Beach, MS 39560-4106 | 2010-03-18 |
| 1578885117 | South Mississippi Regional Center | Intermediate Care Facility, Mentally Retarded | 1170 W Railroad St, Long Beach, MS 39560-4106 | 2010-02-24 |
| 1629091616 | South Mississippi Regional | Pharmacy | 1170 W Railroad St, Long Beach, MS 39560-4106 | 2006-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336660786 | Vitas Laboratory LLC | Clinical Medical Laboratory | 2048 Pineville Road, Suite B, Long Beach, MS 39560 | 2017-07-06 |
| 1760889554 | Laura Catherine Ranson | Physical Therapist | 2 Tower Plaz, Suite B, Community Rehab Center, Long Beach, MS 39560 | 2014-11-24 |
| 1073803714 | Kathleen Ann Williams | Pharmacist | Riteaid #7227 Pharmacy 200 West Railroad St, Suite B, Long Beach, MS 39560 | 2011-04-14 |
| 1609177179 | Robert William Wylie | Hearing Instrument Specialist | 100 Larosa Rd, Ste D, Long Beach, MS 39560 | 2010-11-15 |
| 1891026498 | James Paul Bertinato | Speech-Language Pathologist | 20337 Longview Rd, Long Beach, MS 39560 | 2010-01-21 |
| 1639317274 | Robert A Wiemer Jr. | Pain Medicine | 528-f Klondike Road, Long Beach, MS 39560 | 2009-02-03 |
| 1932362324 | Family Physical Therapy of South Ms LLC | Physical Therapist | 100-a La Rosa Rd, Long Beach, MS 39560 | 2008-07-07 |
| 1952589863 | Miller-whitmer Family Chiropractic | Chiropractor | 125 Jeff Davis Avenue, Long Beach, MS 39560 | 2008-02-01 |
| 1528267333 | Rachel S Conrad Md PC | Family Medicine | 100a Larosa, Long Beach, MS 39560 | 2007-07-12 |
| 1386720241 | Betty Diane Edrington | Registered Nurse | 2 Tower Plaza, Pineville Road, Long Beach, MS 39560 | 2006-10-31 |
| Find all providers in zip 39560 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417132317 | Best Care Home 2 | Intermediate Care Facility, Mentally Retarded | 6467 California Ave, Long Beach, CA 90805-2409 | 2008-01-09 |
| 1427265800 | Bixby Knoll Place | Intermediate Care Facility, Mentally Retarded | 3706 Pine Ave, Long Beach, CA 90807-3258 | 2007-05-16 |
| 1578885117 | South Mississippi Regional Center | Intermediate Care Facility, Mentally Retarded | 1170 W Railroad St, Long Beach, MS 39560-4106 | 2010-02-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578703583 | F Lee Neal Jr Md Pa | Intermediate Care Facility, Mentally Retarded | 717 S Church St, Brookhaven, MS 39601-3811 | 2009-03-03 |
| 1750448718 | Hudspeth Regional Center | Intermediate Care Facility, Mentally Retarded | Highway 475 South, Whitfield, MS 39193 | 2007-01-02 |
| 1326068834 | Boswell Regional Center | Intermediate Care Facility, Mentally Retarded | 1049 Simpson Highway 149 South, Magee, MS 39111-0128 | 2006-07-20 |
| 1346222163 | Preferred Care Developmental Centers of Ms I Inc | Intermediate Care Facility, Mentally Retarded | 200 Womack St, Starkville, MS 39759-2232 | 2005-11-17 |
| 1174505010 | Preferred Care Developmental Centers of Ms I Inc | Intermediate Care Facility, Mentally Retarded | 524 Brookman Dr, Brookhaven, MS 39601-2384 | 2005-11-16 |
| 1710969787 | Preferred Care Developmental Centers of Ms I, Inc. | Intermediate Care Facility, Mentally Retarded | 701 Highway 322, Clarksdale, MS 38614-4722 | 2005-11-16 |
| 1659353688 | Preferred Care Developmental Centers of Ms I Inc | Intermediate Care Facility, Mentally Retarded | 1145 Tisdale Ave, Canton, MS 39046-4965 | 2005-11-16 |
| 1346234184 | Hudspeth Center Pharmacy | Intermediate Care Facility, Mentally Retarded | Highway 475, Whitfield, MS 39193 | 2005-09-08 |
| 1275901167 | Baptist Homes Inc | Intermediate Care Facility, Mentally Retarded | 461 Goodloe Rd, Canton, MS 39046-9740 | 2015-09-09 |
| 1316377633 | Hudspeth Regional Center | Intermediate Care Facility, Mentally Retarded | 100 Hudspeth Center Drive, Whitfield, MS 39193 | 2013-11-22 |
| Find all providers with the same taxonomy | ||||
| City | LONG BEACH |
| Zip Code | 39560 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.