MISSISSIPPI BAND OF CHOCTAW INDIANS (NPI# 1144305731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144305731 |
| Entity Type | Organization |
| Organization Name | MISSISSIPPI BAND OF CHOCTAW INDIANS |
| Other Organization Name | BOGUE CHITTO SATELLITE CLINIC |
| Practice Address |
124 Big Creek Cir Philadelphia MS 39350-9004 |
| Mailing Address |
210 Hospital Cir Choctaw MS 39350-6781 |
| Practice Telephone | 6016562211 |
| Practice Fax Number | 6016637721 |
| Mailing Telephone | 6016562211 |
| Mailing Fax Number | 6016637721 |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2012-06-15 |
| Authorized Official Name | MRS. PHYLLIS J ANDERSON (TRIBAL CHIEF) |
| Authorized Official Telephone | 6016562211 |
| Is Organization Subpart | Y |
| Parent Organization Name | MISSISSIPPI BAND OF CHOCTAW INDIANS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP0904X |
Clinic/Center Specialization: Public Health, Federal |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| BOGUE CHITTO SATELLITE CLINIC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013092600 | Mississippi Band of Choctaw Indians | Clinic/Center | 376 Campus Rd, Conehatta, MS 39057-2800 | 2006-10-25 |
| 1548358153 | Mississippi Band of Choctaw Indians | Ambulance | 210 Hospital Circle, Choctaw, MS 39350-6781 | 2006-10-10 |
| 1154379469 | Mississippi Band of Choctaw Indians | Nursing Facility/Intermediate Care Facility | 135 Hospital Cir, Choctaw, MS 39350-6780 | 2006-05-05 |
| 1114240421 | Mississippi Band of Choctaw Indians | Optometrist | 210 Hospital Cir, Choctaw, MS 39350-6781 | 2010-03-02 |
| 1891965612 | Mississippi Band of Choctaw Indians | Nursing Facility/Intermediate Care Facility | 135 Hospital Cir, Choctaw, MS 39350-6780 | 2008-03-07 |
| 1255533758 | Mississippi Band of Choctaw Indians | Clinic/Center | 210 Hospital Cir, Choctaw, MS 39350-6781 | 2007-06-05 |
| 1073715579 | Mississippi Band of Choctaw Indians | Dentist | 210 Hospital Cir, Choctaw, MS 39350-6781 | 2007-06-05 |
| 1275611543 | Mississippi Band of Choctaw Indians | Clinic/Center | 1930 N Pearl St, Carthage, MS 39051-8220 | 2006-11-02 |
| 1790865780 | Mississippi Band of Choctaw Indians | General Acute Care Hospital | 210 Hospital Cir, Choctaw, MS 39350-6781 | 2006-10-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MISSISSIPPI BAND OF CHOCTAW INDIANS | 101 Industrial Rd, Choctaw, MS 39350-4224 |
| Street Address |
124 BIG CREEK CIR |
| City | PHILADELPHIA |
| State | MS |
| Zip Code | 39350-9004 |
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|---|---|---|---|---|
| 1548817133 | Airpark Family Dentistry | Dentist | 1060 Holland Avenue, Philadelphia, MS 39350 | 2019-08-20 |
| 1396303962 | Medical Foundation Inc | Obstetrics & Gynecology | Rush Medical Group / Philadelphia, 1106 Central Drive, Ste 3, Philadelphia, MS 39350 | 2019-05-30 |
| 1144759580 | Mapp Home Care Services | In Home Supportive Care | 41 Eastover Dr, Philadelphia, MS 39350 | 2017-06-08 |
| 1710411707 | Rcg Mississippi, Inc. | Clinic/Center | 1100 Central Drive, Philadelphia, MS 39350 | 2017-04-17 |
| 1114339405 | Bernard Oneal | Adult Companion | 10090 Rd 0022, None, Philadelphia, MS 39350 | 2014-05-21 |
| 1417213323 | Region Ten Commision On Mental Health | Clinic/Center | 1011 Posey Avenue, Philadelphia, MS 39350 | 2012-04-04 |
| 1851427132 | Performance Therapy LLC | Physical Therapist | Performance Therapy, LLC, 921 W Beacon Street, Philadelphia, MS 39350 | 2007-02-23 |
| 1922161900 | Ernest Barton Cross | Audiologist | 1120 East Main Street, Suite 4, Philadelphia, MS 39350 | 2006-12-19 |
| 1649348129 | Augustus P Soriano | Family Medicine | 517 Center Avenue, Philadelphia, MS 39350 | 2006-12-01 |
| 1982777983 | Bill G Molpus | Dentist | 247 Byrd Ave, Philadelphia, MS 39350 | 2006-11-16 |
| Find all providers in zip 39350 | ||||
| Taxonomy Code | 261QP0904X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Public Health, Federal |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013092600 | Mississippi Band of Choctaw Indians | Clinic/Center | 376 Campus Rd, Conehatta, MS 39057-2800 | 2006-10-25 |
| 1255533758 | Mississippi Band of Choctaw Indians | Clinic/Center | 210 Hospital Cir, Choctaw, MS 39350-6781 | 2007-06-05 |
| 1275611543 | Mississippi Band of Choctaw Indians | Clinic/Center | 1930 N Pearl St, Carthage, MS 39051-8220 | 2006-11-02 |
| City | PHILADELPHIA |
| Zip Code | 39350 |
Please comment or provide details below to improve the information on MISSISSIPPI BAND OF CHOCTAW INDIANS.
| 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.