EAST MISSISSIPPI STATE HOSPITAL (NPI# 1346522653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346522653 |
| Entity Type | Organization |
| Organization Name | EAST MISSISSIPPI STATE HOSPITAL |
| Other Organization Name | MAGNOLIA MEDICAL CLINIC |
| Practice Address |
1818 College Drive Meridian MS 39307-5429 |
| Practice Telephone | 6015817562 |
| Practice Fax Number | 6015817676 |
| Mailing Telephone | 6015817562 |
| Mailing Fax Number | 6015817676 |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2020-05-12 |
| Authorized Official Name | CHARLES CARLISLE (HOSPITAL DIRECTOR) |
| Authorized Official Telephone | 6015817878 |
| Is Organization Subpart | Y |
| Parent Organization Name | EAST MISSISSIPPI STATE HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
31-136 | MS | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Magnolia Medical Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407269756 | East Mississippi State Hospital | Psychiatric Unit | 1401 College Dr, Meridian, MS 39307-5345 | 2014-06-04 |
| 1972689313 | East Mississippi State Hospital | Nursing Facility/Intermediate Care Facility | 4555 Highland Park Drive, Meridian, MS 39307-2903 | 2006-10-27 |
| 1225342173 | East Mississippi State Hospital | Psychiatric Hospital | 4555 Highland Park Drive, Meridian, MS 39307 | 2010-08-03 |
| 1629394853 | East Mississippi State Hospital | Nursing Facility/Intermediate Care Facility | 4555 Highland Park Dr, Meridian, MS 39307-5429 | 2010-04-13 |
| 1841490612 | East Mississippi State Hospital | Dentist | 1818 College Drive, Reimbursement Dept., Meridian, MS 39307-5429 | 2007-07-20 |
| 1649323254 | East Mississippi State Hospital | Psychiatric Hospital | 4555 Highland Park Dr, Meridian, MS 39307 | 2007-01-18 |
| Street Address |
1818 COLLEGE DRIVE |
| City | MERIDIAN |
| State | MS |
| Zip Code | 39307-5429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417930884 | Rolando T. Abangan | Family Medicine | 1818 College Drive, Meridian, MS 39304 | 2005-11-21 |
| 1720694029 | Michelle Gomez Dickerson | Registered Nurse | 1818 College Drive, Meridian, MS 39307 | 2020-09-22 |
| 1770116030 | Briana Shanee Brunson | Nurse Practitioner | 1818 College Drive, Meridian, MS 39307 | 2020-02-14 |
| 1619507407 | Brenda A Thompson | Nurse Practitioner | 1818 College Drive, Meridian, MS 39307 | 2020-01-21 |
| 1205466414 | Arlene Edwards | Nurse Practitioner | 1818 College Drive, Meridian, MS 39307 | 2020-01-16 |
| 1992260129 | Anna E Hollingshead | Nurse Practitioner | 1818 College Drive, Meridian, MS 39304 | 2019-02-01 |
| 1912461328 | Talmadge Rhodes Gray | Nurse Practitioner | 1818 College Drive, Meridian, MS 39305 | 2019-01-30 |
| 1346724598 | Mary Ellen Taylor | Nurse Practitioner | 1818 College Drive, Meridian, MS 39304 | 2018-09-23 |
| 1477030062 | Melanie Rae Howse | Nurse Practitioner | 1818 College Drive, Meridian, MS 39304 | 2018-07-26 |
| 1215300736 | Keri W Barr | Nurse Practitioner | 1818 College Drive, Meridian, MS 39307 | 2015-11-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841824232 | Erica Sheree Smith | Registered Nurse | 1818 College Dr, Meridian, MS 39307 | 2020-02-25 |
| 1518481480 | Derrick Pringle | Social Worker | 110 48th Ave, Meridian, MS 39307 | 2017-08-01 |
| 1821519547 | Leslie Rutkowski | Student in an Organized Health Care Education/Training Program | 2514 67th Avenue Loop Suite 112, Meridian, MS 39307 | 2017-07-03 |
| 1811254931 | Meridian Community College | Dentist | 910 Highway 19 North, Meridian, MS 39307 | 2012-04-13 |
| 1548533672 | Carvan Lorraine Carter | Counselor | 1807 39th Pl, Meridian, MS 39307 | 2012-02-21 |
| 1699921148 | Sara B Smith | Counselor | 1415 College Drive, Meridian, MS 39307 | 2008-08-15 |
| 1285856112 | Jan Parr Boggs | Psychologist | 1508 37th Avenue, Meridian, MS 39307 | 2007-05-02 |
| 1437644564 | Ronni Rebekah Naramore | Family Medicine | 2514 67th Avenue Loop Ste 112, Meridian, MS 39307 | 2018-07-01 |
| 1750876876 | Dennis L Matthews | Family Medicine | 2514 67th Avenue Loop Ste 112, Meridian, MS 39307 | 2018-07-01 |
| 1548792732 | Rachel Claire Harper | Family Medicine | 2514 67th Avenue Loop Ste 112, Meridian, MS 39307 | 2017-03-28 |
| Find all providers in zip 39307 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609327022 | Finding Home Healthcare, Inc. | Clinic/Center | 55 W Willowbrook Dr Ste 103, Meridian, ID 83646 | 2016-10-20 |
| 1386009835 | Teton Healthcare, Inc. | Clinic/Center | 63 W Willowbrook Dr, Meridian, ID 83646-1656 | 2015-12-29 |
| 1558679902 | Physician Group | Clinic/Center | 4555 Highland Park Dr, Meridian, MS 39307-5429 | 2010-09-20 |
| 1104045392 | Saint Alphonsus Regional Medical Center Inc | Clinic/Center | 3025 W Cherry Ln, Suite D, Meridian, ID 83642 | 2007-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487201372 | Caleb Mountain Climbing Wholistic International Center LLC | Clinic/Center | 610 Adeline St Ste 1a, Hattiesburg, MS 39401-3875 | 2019-08-24 |
| 1700440369 | Gentle Hands Healthcare LLC | Clinic/Center | 135 Oak Meadow Dr, Clinton, MS 39056-6044 | 2019-04-29 |
| 1629530795 | A Port In The Storm (apits) | Clinic/Center | 102 N. Cass Street, Suite B, Corinth, MS 38834 | 2019-04-05 |
| 1730502055 | Hancock Medical Health Services | Clinic/Center | 5435 Gex Road, Diamondhead, MS 39525 | 2014-01-22 |
| 1538478870 | Hancock Medical Health Services, Inc. | Clinic/Center | 100 Hancock Square Dr, Bay St Louis, MS 39520-1632 | 2010-10-05 |
| 1629287719 | Singing River Health System | Clinic/Center | 7001 Highway 614, Moss Point, MS 39562 | 2007-05-22 |
| 1164422580 | Mississippi University for Women | Clinic/Center | 620 10th St South, Cromwell Bldg Room 129, Columbus, MS 39701 | 2005-07-28 |
| 1578129177 | Madison Hma LLC | Clinic/Center | 161 River Oaks Dr, Canton, MS 39046-5375 | 2019-05-20 |
| 1902361660 | Sog Physical Therapy | Clinic/Center | 1211 S Gloster St Ste C, Tupelo, MS 38801-6535 | 2019-02-07 |
| 1558897744 | Asa LLC | Clinic/Center | 1924 30th Ave, Gulfport, MS 39501-4534 | 2017-05-07 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on EAST MISSISSIPPI STATE HOSPITAL.
| 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.