CHOCTAW REGIONAL MEDICAL CENTER (NPI# 1174931844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174931844 |
| Entity Type | Organization |
| Organization Name | CHOCTAW REGIONAL MEDICAL CENTER |
| Other Organization Name | CHOCTAW MEDICAL CLINIC OF WEIR |
| Practice Address |
780 Main St Weir MS 39772-9058 |
| Mailing Address |
Po Box 719 Ackerman MS 39735-0719 |
| Practice Telephone | 6625479407 |
| Mailing Telephone | 6622854400 |
| Enumeration Date | 2014-07-25 |
| Last Update Date | 2014-07-25 |
| Authorized Official Name | JAMIE RODGERS (ADMINISTRATOR) |
| Authorized Official Telephone | 6622854400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Choctaw Medical Clinic Of Weir | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538555347 | Choctaw Regional Medical Center | Family Medicine | 14724 Highway 15 N, Louisville, MS 39339-6318 | 2015-04-08 |
| 1225446578 | Choctaw Regional Medical Center | Personal Emergency Response Attendant | 8613 Ms Highway 12, Ackerman, MS 39735-8917 | 2014-07-31 |
| 1609284959 | Choctaw Regional Medical Center | Medicare Defined Swing Bed Unit | 8613 Ms Highway 12, Ackerman, MS 39735-8917 | 2014-07-31 |
| 1235547878 | Choctaw Regional Medical Center | Clinic/Center | 64 N Louisville St, Ackerman, MS 39735-9217 | 2014-07-28 |
| 1285041582 | Choctaw Regional Medical Center | Medicare Defined Swing Bed Unit | 8613 Ms Highway 12, Ackerman, MS 39735-8917 | 2014-07-18 |
| 1003223306 | Choctaw Regional Medical Center | Clinic/Center | 8613 Ms Highway 12, Ackerman, MS 39735-8917 | 2014-07-18 |
| 1568879864 | Choctaw Regional Medical Center | Personal Emergency Response Attendant | 8613 Ms Highway 12, Ackerman, MS 39735-8917 | 2014-07-18 |
| 1518374875 | Choctaw Regional Medical Center | Skilled Nursing Facility | 311 W Cherry St, Ackerman, MS 39735-8708 | 2014-07-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CHOCTAW REGIONAL MEDICAL CENTER | 8613 Ms Highway 12, Ackerman, MS 39735-8917 |
| Street Address |
780 MAIN ST |
| City | WEIR |
| State | MS |
| Zip Code | 39772-9058 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386850733 | Angela Montgomery | Dentist | 392 Front St, Weir, MS 39772 | 2007-05-15 |
| 1982659405 | Brandywine Health Services of Mississippi, Inc | Clinic/Center | 547 Front St., Weir, MS 39772 | 2006-05-23 |
| 1730461211 | Pioneer Health Services of Choctaw County, LLC | Clinic/Center | 780 Main Street, Weir, MS 39772-0000 | 2011-09-12 |
| 1063711349 | Choctaw County | Clinic/Center | 780 Main Street, Weir, MS 39772-0000 | 2011-03-25 |
| 1740526961 | Better Living Home Care, LLC | Skilled Nursing Facility | 1295 Simpson Park Rd, Weir, MS 39772-8805 | 2012-12-14 |
| 1437791019 | Mae Helen Carraway | Technician | 1183 Simpson Park Rd, Weir, MS 39772-8806 | 2019-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437791019 | Mae Helen Carraway | Technician | 1183 Simpson Park Rd, Weir, MS 39772-8806 | 2019-10-15 |
| 1740526961 | Better Living Home Care, LLC | Skilled Nursing Facility | 1295 Simpson Park Rd, Weir, MS 39772-8805 | 2012-12-14 |
| 1962607572 | Laura Ann Ferlo | Counselor | 807 S Washington St, Weir, KS 66781-4230 | 2007-06-15 |
| 1386850733 | Angela Montgomery | Dentist | 392 Front St, Weir, MS 39772 | 2007-05-15 |
| 1982659405 | Brandywine Health Services of Mississippi, Inc | Clinic/Center | 547 Front St., Weir, MS 39772 | 2006-05-23 |
| 1932176567 | Nancy Stultz | Nurse Anesthetist, Certified Registered | 5419 Ne Highway 103, Weir, KS 66781-4124 | 2006-03-02 |
| 1730461211 | Pioneer Health Services of Choctaw County, LLC | Clinic/Center | 780 Main Street, Weir, MS 39772-0000 | 2011-09-12 |
| 1063711349 | Choctaw County | Clinic/Center | 780 Main Street, Weir, MS 39772-0000 | 2011-03-25 |
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982659405 | Brandywine Health Services of Mississippi, Inc | Clinic/Center | 547 Front St., Weir, MS 39772 | 2006-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730786120 | Ochsner Medical Center - Hancock, LLC | Clinic/Center | 2274 Highway 43 S Ste 200, Picayune, MS 39466-8141 | 2020-10-08 |
| 1306460282 | Covington County Hospital | Clinic/Center | 105 Eaton St, Taylorsville, MS 39168-5614 | 2020-06-05 |
| 1871117747 | Covington County Hospital | Clinic/Center | 1039 Highway 42 Ste C, Sumrall, MS 39482-4478 | 2020-06-05 |
| 1194365338 | Bounds Family Medical | Clinic/Center | 870 Main St Ste A, Fayette, MS 39069-5695 | 2020-01-15 |
| 1720649577 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 19 Third St, Belmont, MS 38827 | 2019-06-24 |
| 1255999611 | Boa Vida Hospital of Aberdeen, Ms LLC | Clinic/Center | 400 3rd Ave 32 West, New Houlka, MS 38850 | 2019-05-31 |
| 1598238545 | South Sunflower County Hospital | Clinic/Center | 1001 West Delta, Moorhead, MS 38761 | 2019-01-02 |
| 1790272185 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 670 Ms-178, Suite 5, Sherman, MS 38869 | 2018-04-20 |
| 1124515515 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 2200 5th St N, Columbus, MS 39705-2212 | 2018-04-20 |
| 1205323698 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 815 2nd Ave N, Columbus, MS 39701-4703 | 2018-04-20 |
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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.