SOUTHERN HEALTH CORP. OF HOUSTON, INC. (NPI# 1194833400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194833400 |
| Entity Type | Organization |
| Organization Name | SOUTHERN HEALTH CORP. OF HOUSTON, INC. |
| Other Organization Name | TRACE FAMILY HEALTH & INTERNAL MEDICINE |
| Practice Address |
1002 E Madison St Houston MS 38851-2417 |
| Mailing Address |
Po Box 432 Houston MS 38851-0432 |
| Practice Telephone | 6624562800 |
| Practice Fax Number | 6624561715 |
| Mailing Telephone | 6624562800 |
| Mailing Fax Number | 6624561715 |
| Enumeration Date | 2006-08-27 |
| Last Update Date | 2010-11-30 |
| Authorized Official Name | MR. GARY STATEN (CEO) |
| Authorized Official Telephone | 6624561000 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | MEDICARE PART B GROUP | C02335 | 01 |
| MS | 07978511 | 05 | |
| MS | TRISPAN | 258518 | 01 |
| Other Name | Type Code |
|---|---|
| Trace Family Health & Internal Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003096488 | Southern Health Corp. of Houston, Inc. | Clinic/Center | 1002 E Madison St, Houston, MS 38851-2417 | 2007-11-14 |
| 1922174655 | Southern Health Corp. of Houston, Inc. | Clinic/Center | 521 West Dr, Okolona, MS 38860-1625 | 2006-11-27 |
| Street Address |
1002 E MADISON ST |
| City | HOUSTON |
| State | MS |
| Zip Code | 38851-2417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750383972 | James R. Staten | Surgery | 1002 E Madison St, Houston, MS 38851-2417 | 2005-06-01 |
| 1235736778 | Bethany Anna Free | Nurse Practitioner | 1002 E Madison St, Houston, MS 38851-2428 | 2020-10-07 |
| 1013484864 | Meagan Zepeda Hillhouse | Nurse Practitioner | 1002 E Madison St, Houston, MS 38851-2428 | 2018-10-30 |
| 1780924282 | Hospitalmd of Ms Ip, Inc | Emergency Medicine | 1002 E Madison St, Houston, MS 38851-2428 | 2013-02-20 |
| 1073853578 | Hospitalmd of Ms, Inc | Emergency Medicine | 1002 E Madison St, Houston, MS 38851-2428 | 2013-02-20 |
| 1508154501 | Katie Melia Gann | Nurse Practitioner | 1002 E Madison St, Suite 2, Houston, MS 38851-2428 | 2011-07-12 |
| 1487966750 | Robert David Herring Jr. | Family Medicine | 1002 E Madison St, Houston, MS 38851-2428 | 2010-07-02 |
| 1942484365 | Southern Health Corp. of Houston, Inc | Nurse Anesthetist, Certified Registered | 1002 E Madison St, Houston, MS 38851-2417 | 2007-12-20 |
| 1003096488 | Southern Health Corp. of Houston, Inc. | Clinic/Center | 1002 E Madison St, Houston, MS 38851-2417 | 2007-11-14 |
| 1174745947 | Victor Horn | Nurse Practitioner | 1002 E Madison St, Ste 2, Houston, MS 38851-2417 | 2007-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144742073 | Natalie Mitchell | Social Worker | 102 Okolona Cutoff Rd, Houston, MS 38851 | 2017-07-12 |
| 1073041042 | Jan Sherlene Paden | Nurse Practitioner | 8 East Madison St, Houston, MS 38851 | 2017-06-02 |
| 1851772818 | Shell Denece Williams-moore | Religious Nonmedical Practitioner | 901 North Jackson Street, Houston, MS 38851 | 2015-06-16 |
| 1740385491 | Southern Health Corp of Houston Inc | Skilled Nursing Facility | 1000 East Madison, Houston, MS 38851 | 2006-09-14 |
| 1730281809 | Teena Freeman Horn | Dentist | 327 N Jackson St, Houston, MS 38851 | 2006-09-01 |
| 1891776530 | Kunthavai S. Patel | Specialist | 208 Country Club Road, Houston, MS 38851 | 2005-11-09 |
| 1255467726 | North Mississippi Foot Specialists PC | Durable Medical Equipment & Medical Supplies | Hwy 8 East, Houston, MS 38851 | 2007-02-26 |
| 1689753485 | Southern Health Corp of Houston Inc | Psychiatric Unit | Highway 8 East, Houston, MS 38851 | 2006-11-03 |
| 1306925102 | Southern Health Corp of Houston Inc | Medicare Defined Swing Bed Unit | Highway 8 East, Houston, MS 38851 | 2006-11-03 |
| 1134212038 | Chickasaw Dental Group L. L. C. | Dentist | 327 N Jackson St, Houston, MS 38851 | 2006-10-02 |
| Find all providers in zip 38851 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548731169 | Texas County Memorial Hospital | Clinic/Center | 1422 S Sam Houston Blvd, Houston, MO 65483-2130 | 2018-12-07 |
| 1073920328 | Pontotoc Health Services, Inc. | Clinic/Center | 208 Country Club Rd, Houston, MS 38851-9326 | 2014-07-18 |
| 1548608748 | Mercy St Francis Hospital | Clinic/Center | 1422 S Sam Houston Blvd, Houston, MO 65483-2130 | 2013-06-10 |
| 1710004486 | Texas County Memorial Hospital | Clinic/Center | 1337 S Sam Houston Blvd, Suite 200, Houston, MO 65483-2046 | 2007-03-26 |
| 1063539732 | Texas County Memorial Hospital | Clinic/Center | 1335 S Sam Houston Blvd, Houston, MO 65483-2046 | 2007-03-26 |
| 1083721732 | Southern Health Corp. of Houston, Inc | Clinic/Center | 105 Hillcrest Dr, Houston, MS 38851-2430 | 2006-08-25 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.