TALLAHATCHIE GENERAL HOSPITAL (NPI# 1194860502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194860502 |
| Entity Type | Organization |
| Organization Name | TALLAHATCHIE GENERAL HOSPITAL |
| Other Organization Name | CHARLESTON RURAL HEALTH CLINIC |
| Practice Address |
401 S Church St Charleston MS 38921-2257 |
| Mailing Address |
Po Box 27 401 S Church St Charleston MS 38921-0027 |
| Practice Telephone | 6626475535 |
| Practice Fax Number | 6626478432 |
| Mailing Telephone | 6626475535 |
| Mailing Fax Number | 6626478432 |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2010-07-07 |
| Authorized Official Name | MRS. BERNIDIENNE CARSON LATTIMORE (BILLING MANAGER) |
| Authorized Official Telephone | 6626475535 |
| Authorized Official Credential | CBCS, CHI |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC0050X |
Clinic/Center Specialization: Critical Access Hospital |
MS | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09014008 | 05 |
| Other Name | Type Code |
|---|---|
| CHARLESTON RURAL HEALTH CLINIC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932591468 | Tallahatchie General Hospital | Family Medicine | 195 Highway 35 S, Holcomb, MS 38940 | 2015-02-20 |
| 1346734373 | Tallahatchie General Hospital | Pharmacy | 109 W Walnut St, Charleston, MS 38921-2242 | 2018-06-22 |
| 1609322205 | Tallahatchie General Hospital | Clinic/Center | 205 Alma St, Tutwiler, MS 38963-5067 | 2016-09-01 |
| 1215267232 | Tallahatchie General Hospital | General Acute Care Hospital | 201 S Market St, Charleston, MS 38921-2236 | 2010-01-14 |
| 1679733497 | Tallahatchie General Hospital | Personal Emergency Response Attendant | 201 S Market St, Pob 230, Charleston, MS 38921-2236 | 2008-06-16 |
| 1992706303 | Tallahatchie General Hospital | Medicare Defined Swing Bed Unit | 201 S Market St, Charleston, MS 38921-2236 | 2005-08-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | TALLAHATCHIE GENERAL HOSPITAL & EXTENDED CARE FACILITY | 201 S Market St, Charleston, MS 38921-2236 |
| System for Award Management (SAM) Entities | TALLAHATCHIE GENERAL HOSPITAL MEDICAL FOUNDATION | 201 S Market St, Charleston, MS 38921-2236 |
| Street Address |
401 S CHURCH ST |
| City | CHARLESTON |
| State | MS |
| Zip Code | 38921-2257 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477644466 | Yolanda K Berkley | Nurse Practitioner | 401 S Church St, Charleston, MS 38921-2257 | 2006-09-27 |
| 1013559426 | Jessica Elizabeth Mcgee | Nurse Practitioner | 401 S Church St, Charleston, MS 38921-2257 | 2019-10-17 |
| 1447891692 | Audrey Leann Williamson | Nurse Practitioner | 401 S Church St, Charleston, MS 38921-2257 | 2019-09-30 |
| 1679124713 | Catherine Moring | Dietitian, Registered | 401 S Church St, Charleston, MS 38921-2257 | 2019-09-20 |
| 1417425620 | Raedena L Hill | Nurse Practitioner | 401 S Church St, Charleston, MS 38921-2257 | 2018-11-06 |
| 1134596919 | Cassala Ward | Nurse Practitioner | 401 S Church St, Charleston, MS 38921-2257 | 2015-08-27 |
| 1801287883 | Shana Belle Smith | Nurse Practitioner | 401 S Church St, Charleston, MS 38921-2257 | 2015-02-11 |
| 1457796922 | Monica Joy Carter | Nurse Practitioner | 401 S Church St, Charleston, MS 38921-2257 | 2013-05-09 |
| 1568766145 | Lisa Bradham | Nurse Practitioner | 401 S Church St, Charleston, MS 38921-2257 | 2010-12-22 |
| 1831329887 | Charleston Clinic | Nurse Practitioner | 401 S Church St, Charleston, MS 38921-2257 | 2009-07-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538717459 | Square Drugs, LLC | Pharmacy | 126 Court Square, Charleston, MS 38921 | 2019-09-04 |
| 1588015341 | Kyle Wiggins | Dentist | 203 South Market St, Charleston, MS 38921 | 2016-06-23 |
| 1659555761 | Tallahatchie General Hospital and Extended Care Facility | Nursing Facility/Intermediate Care Facility | 201 South Market Street, Charleston, MS 38921 | 2007-12-26 |
| 1316152010 | Wolfe Family Medical Clinic Pllc | Clinic/Center | 203 E Walnut St, Charleston, MS 38921 | 2007-05-14 |
| 1962617530 | East Tallahatchie Schools | Registered Nurse | 35 Oak Grove Road, Charleston, MS 38921 | 2007-05-14 |
| 1518052661 | Carlene Maynor Wolfe | Nurse Practitioner | 204 East Walnut Street, Charleston, MS 38921 | 2006-10-04 |
| 1003921172 | James Oscar Wilde Jr. | Family Medicine | 201 S. Market St., Charleston, MS 38921 | 2006-08-20 |
| 1851919658 | Delta Med South, Inc. | Durable Medical Equipment & Medical Supplies | 7 Court Sq, Charleston, MS 38921 | 2020-07-08 |
| 1932616950 | Sharon Bradley | Homemaker | 29 Nell St, Charleston, MS 38921-1424 | 2017-12-30 |
| 1649595505 | Lasuna M Curry | Counselor | 17 N Market St, Charleston, MS 38921-1524 | 2010-04-05 |
| Find all providers in zip 38921 | ||||
| Taxonomy Code | 261QC0050X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Critical Access Hospital |
| An outpatient entity, facility, or distinct part of a facility within or affiliated with a Critical Access Hospital that provides access to primary care services for individuals in a small rural community and is Medicare certified. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306983903 | Stone County Hospital, Inc. | Clinic/Center | 1222 S Main, Poplarville, MS 39470 | 2007-01-31 |
| 1609322205 | Tallahatchie General Hospital | Clinic/Center | 205 Alma St, Tutwiler, MS 38963-5067 | 2016-09-01 |
| 1417146259 | Prentiss Regional Hospital and Ecf, Inc. | Clinic/Center | 4297 Highway 42, Bassfield, MS 39421 | 2007-10-17 |
| City | CHARLESTON |
| Zip Code | 38921 |
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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.