SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.


Address: 215 Old Highway 49 E, Brooklyn, MS 39425-9028
Phone: 6015458700

SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC. (NPI# 1407363559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1407363559
Entity Type Organization
Organization Name SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.
Other Organization Name FORREST AGRICULTURAL HIGH SCHOOL
Practice Address 215 Old Highway 49 E
Brooklyn
MS 39425-9028
Mailing Address Po Box 1729
Hattiesburg
MS 39403-1729
Practice Telephone 6015458700
Practice Fax Number 6014502493
Mailing Telephone 6015458700
Mailing Fax Number 6014502493
Enumeration Date 2018-01-10
Last Update Date 2018-01-12
Authorized Official Name GEROLDEAN M DYSE (CHIEF EXECUTIVE OFFICER)
Authorized Official Telephone 6015458700
Authorized Official Credential CEO
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QF0400X Clinic/Center
Specialization: Federally Qualified Health Center (FQHC)
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Forrest Agricultural High School Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1952814469 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 64 Old Airport Rd, Hattiesburg, MS 39401-8382 2017-11-07
1053862524 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 104 Carver Drive, Collins, MS 39428 2016-10-20
1477004463 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 824 Hopewell Rd, Collins, MS 39428-5736 2016-10-14
1942751938 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 1208 Dogwood Ave, Collins, MS 39428-4160 2016-10-14
1457800146 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 301 South 4th Street, Mount Olive, MS 39119-0000 2016-09-23
1497202527 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 401 Dogwood Street, Collins, MS 39428-0000 2016-09-07
1184961153 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 60 Herrington Rd, Petal, MS 39465-8842 2013-01-11
1932446051 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 1179 Highway 42, Petal, MS 39465-9740 2013-01-09
1427328889 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 301 Hutchinson Ave, Hattiesburg, MS 39401-4134 2012-01-03
1265461719 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 100 W Front St, Hattiesburg, MS 39401-3460 2006-06-30

Office Location

Street Address 215 OLD HIGHWAY 49 E
City BROOKLYN
State MS
Zip Code 39425-9028

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1477884674 Lisa Gayle Smith Speech-Language Pathologist 130 Sam Boyte Rd, Brooklyn, MS 39425-9501 2010-01-27
1659348076 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 44 Brooklyn Janice Rd, Brooklyn, MS 39425-9731 2006-03-03
1659844496 Charles F Diamond Nurse Practitioner 44 Brooklyn Janice Rd, Brooklyn, MS 39425-9731 2019-01-04
1568867455 Kaylora L Bingham Nurse Practitioner 44 Brooklyn Janice Rd, Brooklyn, MS 39425-9731 2014-11-04
1306881149 Southeast Mississippi Rural Health Initiative, Inc Clinic/Center 8 Burborne St, Brooklyn, MS 39425-9732 2006-06-17

Providers in the same city

NPI Name Taxonomy Address Enumeration
1184225880 Aleksandr Gurgov Nurse Practitioner 740 E 9th St, Brooklyn, NY 11230-2202 2020-11-08
1255932935 Emily W Wang Speech-Language Pathologist 486 E 28th St Apt 702, Brooklyn, NY 11226-7994 2020-11-08
1396346136 Amarachukwu U Egbujor Nurse Practitioner 565 Pine St, Brooklyn, NY 11208-3901 2020-11-06
1225639099 Munisa Mukhamatkulova Specialist 1133 E 73rd St, Brooklyn, NY 11234-5409 2020-11-06
1740881663 Lauren Amigo Art Therapist 86 Fleet Pl Apt 5t, Brooklyn, NY 11201-7132 2020-11-06
1326649146 Cosmic Psych-medx Marriage & Family Therapist 2065 E 54th St Apt 2, Brooklyn, NY 11234-4750 2020-11-06
1437750585 Eric Grant Shorey Psychoanalyst 91 Jewel St Apt 3r, Brooklyn, NY 11222-3025 2020-11-05
1700487774 Rebecca Kason Psychologist 38 Broome St Apt 2b, Brooklyn, NY 11222-5515 2020-11-05
1477154540 Rachel Steinhardt Counselor 2917 Avenue M Side Door, Brooklyn, NY 11210-4616 2020-11-05
1043811102 Krisja Hendricks Dance Therapist 978 Metropolitan Ave Apt 2, Brooklyn, NY 11211-2635 2020-11-05
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Taxonomy Information

Taxonomy Code 261QF0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Federally Qualified Health Center (FQHC)

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
1962040246 Community Health Project Inc. Clinic/Center 40 Flatbush Avenue Extension, Brooklyn, NY 11201 2019-12-17
1245886753 Care for The Homeless Clinic/Center 91 Junius St, Brooklyn, NY 11212-8021 2019-08-12
1184186496 Oda Primary Health Care Network, Inc. Clinic/Center 74 Wallabout Street, Brooklyn, NY 11249 2019-04-04
1932682838 Hudson River Healthcare, Inc. Clinic/Center 2400 Linden Boulevard, Brightpoint Health Part 822-4 Outpatient Services, Brooklyn, NY 11208-4830 2018-09-07
1568910545 Oda Primary Health Care Network, Inc. Clinic/Center 329 Hewes St, Brooklyn, NY 11211-7474 2016-09-19
1104274745 Premium Health, Inc. Clinic/Center 5506 15th Ave, Brooklyn, NY 11219-4301 2016-05-24
1477909349 Damian Family Care Centers, Inc. Clinic/Center 599 Ralph Ave, Brooklyn, NY 11233 2016-05-10
1619366978 Brooklyn Plaza Medical Center, Inc Clinic/Center 297 Myrtle Ave, Brooklyn, NY 11205-2901 2015-01-09
1730592403 The Floating Hospital Inc. Clinic/Center 515 Blake Ave, Brooklyn, NY 11207-4502 2014-06-10
1275946550 The Floating Hospital Inc. Clinic/Center 10875 Avenue D, Brooklyn, NY 11236-1931 2014-06-04
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Competitor

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City BROOKLYN
Zip Code 39425

Improve Information

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Dataset Information

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.

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