ANDERSON REGIONAL MEDICAL CENTER (NPI# 1043764699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043764699 |
| Entity Type | Organization |
| Organization Name | ANDERSON REGIONAL MEDICAL CENTER |
| Other Organization Name | ANDERSON PROFESSIONAL SERVICES |
| Practice Address |
2124 14th St Meridian MS 39301-4040 |
| Practice Telephone | 6017033480 |
| Practice Fax Number | 6017030124 |
| Mailing Telephone | 6017033480 |
| Mailing Fax Number | 6017030124 |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2020-01-14 |
| Authorized Official Name | MR. JOHN ANDERSON (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6015536000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 08874574 | 05 |
| Other Name | Type Code |
|---|---|
| Anderson Professional Services | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1704 23rd Ave, Meridian, MS 393013103 | 6014855081 | 6014855084 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912305988 | Anderson Regional Medical Center | Family Medicine | 6694 Poplar Springs Drive, Meridian, MS 39305 | 2014-12-08 |
| 1598105447 | Anderson Regional Medical Center | Clinic/Center | 1600 22nd Avenue, Medical Towers 3, 3rd Floor, Suite B, Meridian, MS 39301 | 2013-06-25 |
| 1164078911 | Anderson Regional Medical Center | Obstetrics & Gynecology | 2420 11th St, Meridian, MS 39301-5033 | 2019-08-16 |
| 1376040121 | Anderson Regional Medical Center | Internal Medicine | 2124 14th St, Meridian, MS 39301-4040 | 2018-04-09 |
| 1710352356 | Anderson Regional Medical Center | Clinic/Center | 1523 22nd Ave Ste B, Meridian, MS 39301-4016 | 2015-12-08 |
| 1598104671 | Anderson Regional Medical Center | Clinic/Center | 1404 E Pushmataha St, Butler, AL 36904-2728 | 2013-06-21 |
| 1053750125 | Anderson Regional Medical Center | Clinic/Center | 1056 Holland Ave, Philadelphia, MS 39350-9121 | 2013-06-21 |
| 1285073353 | Anderson Regional Medical Center | Clinic/Center | 2514 67th Avenue Loop, Suite 112, Meridian, MS 39307-7259 | 2013-06-21 |
| 1356780423 | Anderson Regional Medical Center | Clinic/Center | 83a Old Mill Creek Rd, Enterprise, MS 39330-9649 | 2013-06-21 |
| 1558619171 | Anderson Regional Medical Center | Medicare Defined Swing Bed Unit | 1102 Constitution Avenue, Meridian, MS 39301-4001 | 2012-08-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ANDERSON REGIONAL MEDICAL CENTER | 2124 14th St, Meridian, MS 39301-4040 |
| Street Address |
2124 14TH ST |
| City | MERIDIAN |
| State | MS |
| Zip Code | 39301-4040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932181146 | Deborah Sims Parten | Nurse Anesthetist, Certified Registered | 2124 14th St, Suite 202, Meridian, MS 39301-4040 | 2005-11-15 |
| 1023624467 | Lekica Roshelle Boyd | Nurse Practitioner | 2124 14th St, Meridian, MS 39301-4040 | 2020-09-21 |
| 1437768272 | Elaine Blount Rigdon | Nurse Practitioner | 2124 14th St, Meridian, MS 39301-4040 | 2020-07-28 |
| 1801405923 | Melinda Bozeman | Registered Nurse | 2124 14th St, Meridian, MS 39301-4040 | 2020-07-24 |
| 1952936213 | Kevin Hatcher | Registered Nurse | 2124 14th St, Meridian, MS 39301-4040 | 2020-03-06 |
| 1790325124 | Nancy Lynn Brown | Nurse Practitioner | 2124 14th St, Meridian, MS 39301-4040 | 2020-01-14 |
| 1023658705 | Corinna Lynn Dorais | Dietitian, Registered | 2124 14th St, Meridian, MS 39301-4040 | 2020-01-10 |
| 1962045765 | Melissa Dedeaux | Registered Nurse | 2124 14th St, Meridian, MS 39301-4040 | 2019-10-24 |
| 1245889807 | Jamie Agent | Nurse Practitioner | 2124 14th St, Meridian, MS 39301-4040 | 2019-09-06 |
| 1750846473 | Jessica Lewis | Nurse Practitioner | 2124 14th St, Meridian, MS 39301-4040 | 2019-02-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407460439 | Kayla Lee Monsour | Pharmacist | 1415 24th Avenue, Meridian, MS 39301 | 2020-09-08 |
| 1306478359 | K&r Optical Solutions Corporation | Eyewear Supplier (Equipment, not the service) | 3126 8th St., Suite A, Meridian, MS 39301 | 2020-02-07 |
| 1912537317 | Courtney M Hollie | Counselor | 1054 Ms-19, Meridian, MS 39301 | 2020-01-24 |
| 1932636495 | Rcg Mississippi, Inc. | Clinic/Center | 1300 38th Ave E, Meridian, MS 39301 | 2017-05-16 |
| 1811428915 | Tierria Mcglothin | Nurse Practitioner | 1054 Highway 19 S, Meridian, MS 39301 | 2017-03-21 |
| 1154869303 | Lindsay Nemanich | Physical Therapist | 3716 Ms-39, Meridian, MS 39301 | 2017-02-08 |
| 1700323599 | Wal-mart Stores East Lp | Pharmacy | 3310-a Highway 39 North, Meridian, MS 39301 | 2017-01-31 |
| 1972977460 | Southeast Pharmacy LLC | Pharmacy | 2402 Long Creek Road, Meridian, MS 39301 | 2015-11-20 |
| 1235508342 | East Mississippi Oral & Facial Surgery, LLC | Clinic/Center | 1212 24th Avenue, Meridian, MS 39301 | 2015-09-18 |
| 1831580778 | Clarkdale Pharmacy and Gifts LLC | Pharmacy | 6935c Hwy 145, Meridian, MS 39301 | 2015-02-13 |
| Find all providers in zip 39301 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821486812 | Tami Sue Lee | Specialist | 841 E Fairview Ave Ste 100, Meridian, ID 83642-9386 | 2014-12-29 |
| 1164822029 | Robert Francis Malison | Specialist | 3975 E Clocktower Ln Apt 326, Meridian, ID 83642-9141 | 2014-08-28 |
| 1073788337 | Cheree L Eveland | Specialist | 3455 Woodmont Dr, Meridian, ID 83646-1166 | 2008-04-28 |
| 1952504623 | Benjamin Edgar Box | Specialist | 4807 11th Pl, Meridian, MS 39305-2771 | 2007-06-08 |
| 1669594974 | Mark Garry Murray | Specialist | 1400 20th Ave Ste C, Meridian, MS 39301-4103 | 2007-04-06 |
| 1811081896 | Adam M Cope | Specialist | 2176 E Franklin Rd, Suite 100, Meridian, ID 83642-9024 | 2006-10-03 |
| 1366536609 | Charles Guy Riddle | Specialist | 1626 S Wells Ave Ste 105, Meridian, ID 83642-4528 | 2006-10-03 |
| 1043318280 | Lee Kinsey Thornton | Specialist | 5002 Highway 39 N Bldg C, Meridian, MS 39301-1078 | 2006-09-20 |
| 1154423804 | Woody D. Davis | Specialist | 5002 Highway 39 N, Bldg. B, Meridian, MS 39301-1078 | 2006-09-02 |
| 1144275694 | Robert Lantz Davidson | Specialist | 3525 E Louise Dr Ste 195, Meridian, ID 83642 | 2006-05-23 |
| Find all providers in MERIDIAN | ||||
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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.