VICKSBURG HEALTHCARE LLC (NPI# 1568400604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568400604 |
| Entity Type | Organization |
| Organization Name | VICKSBURG HEALTHCARE LLC |
| Other Organization Name | RIVER REGION HEALTH SYSTEM |
| Practice Address |
2100 Highway 61 N Vicksburg MS 39183-8211 |
| Mailing Address |
Po Box 1198 Dept 03-006 Vicksburg MS 39181-1198 |
| Practice Telephone | 6018835175 |
| Practice Fax Number | 6018835197 |
| Mailing Telephone | 6018835175 |
| Mailing Fax Number | 6018835197 |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2007-11-06 |
| Authorized Official Name | LAURIE HOLTSFORD (DIRECTOR, BUSINESS OFFICE SERVICES) |
| Authorized Official Telephone | 6154657466 |
| Is Organization Subpart | Y |
| Parent Organization Name | VICKSBURG HEALTHCARE LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| River Region Health System | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740228881 | Vicksburg Healthcare LLC | Psychiatric Unit | 1111 N Frontage Rd, Vicksburg, MS 39180-5102 | 2006-06-02 |
| 1639799430 | Vicksburg Healthcare LLC | Clinical Medical Laboratory | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2020-04-21 |
| 1629084058 | Vicksburg Healthcare LLC | Emergency Medicine | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2006-07-31 |
| 1659394666 | Vicksburg Healthcare LLC | Emergency Medicine | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2006-07-25 |
| 1659319796 | Vicksburg Healthcare LLC | Rehabilitation Unit | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2006-06-02 |
| 1215981303 | Vicksburg Healthcare LLC | General Acute Care Hospital | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2006-05-21 |
| Street Address |
2100 HIGHWAY 61 N |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39183-8211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457357691 | Tulio Figarola | Orthopaedic Surgery | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2005-06-22 |
| 1639799430 | Vicksburg Healthcare LLC | Clinical Medical Laboratory | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2020-04-21 |
| 1407481880 | Casey Elaine Collier | Physician Assistant | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2020-03-06 |
| 1124682570 | Kpc Promise Hospital of Vicksburg LLC | Long Term Care Hospital | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2019-04-30 |
| 1144789801 | Laura Lavee Burris | Physician Assistant | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2019-03-12 |
| 1134699192 | Lisa Wamsley | Pharmacist | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2018-12-03 |
| 1619456621 | Kimberly Washington | Physical Therapist | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2018-08-09 |
| 1114459070 | Thulasi Ram Gudi | Internal Medicine | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2017-03-30 |
| 1518403617 | Brett Myers Scruggs | Nurse Anesthetist, Certified Registered | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2017-01-12 |
| 1770933731 | Cesar Luis Merino | Hospitalist | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2016-06-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306217823 | Tracy Curtis | Speech-Language Pathologist | 2100 Us 61, Vicksburg, MS 39183 | 2015-10-09 |
| 1649566894 | The Life Balance Clinic, Behavioral Health Service | Social Worker | 1107 B Openwood St., Vicksburg, MS 39183 | 2011-06-27 |
| 1245428788 | Melanie Joan Waldrop | Nurse Anesthetist, Certified Registered | 2100 Hwy 61n, River Region Medical Center, Vicksburg, MS 39183 | 2007-10-10 |
| 1871714477 | Robert Michael Coleman | Dentist | 2356 Grove Street, Vicksburg, MS 39183 | 2007-05-01 |
| 1942363502 | Visions Physical Therapy | Physical Therapist | 110 Holt Collier Dr, Vicksburg, MS 39183 | 2006-12-18 |
| 1023117991 | Janet S Fisher Dmd Pa | Dentist | 1212 Mission 66, Vicksburg, MS 39183 | 2006-09-21 |
| 1407878663 | Annette Bryant | Social Worker | 1107 Openwood St, Vicksburg, MS 39183 | 2006-07-24 |
| 1932168416 | Promise Hospital of Vicksburg Inc | Long Term Care Hospital | 2100 Highway 61 N Fl 6, Vicksburg, MS 39183 | 2006-03-22 |
| 1164945374 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2310 Clay St, Vicksburg, MS 39183 | 2017-07-19 |
| 1811244858 | Life Balance Clinic LLC | Social Worker | 1107 Openwood St, Vicksburg, MS 39183 | 2012-08-09 |
| Find all providers in zip 39183 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548210289 | Covenant Health & Rehab of Vicksburg, Lp | Skilled Nursing Facility | 2850 Porters Chapel Rd, Vicksburg, MS 39180-1805 | 2006-05-11 |
| 1225086374 | Community Care Center of Vicksburg LLC | Skilled Nursing Facility | 3103 Wisconsin Ave, Vicksburg, MS 39180-4825 | 2006-05-04 |
| 1578553459 | Vicksburg Convalescent, LLC | Skilled Nursing Facility | 1708 Cherry St, Vicksburg, MS 39180 | 2005-10-24 |
| 1184613143 | Shady Lawn, LLC | Skilled Nursing Facility | 60 Shady Lawn Pl, Vicksburg, MS 39180 | 2005-10-20 |
| 1215420278 | Nexion Health At Vicksburg, Inc. | Skilled Nursing Facility | 2850 Porters Chapel Rd, Vicksburg, MS 39180-1805 | 2018-06-13 |
| 1972001493 | Porters Chapel Opco, LLC | Skilled Nursing Facility | 60 Shady Lawn Pl, Vicksburg, MS 39180 | 2018-01-30 |
| 1902093396 | The Bluffs Rehabilitation and Healthcare Center, LLC | Skilled Nursing Facility | 2850 Porters Chapel Rd, Vicksburg, MS 39180-1805 | 2007-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427575505 | Trend Health and Rehab of Carthage | Skilled Nursing Facility | 1101 E. Franklin Street, Carthage, MS 39051 | 2017-08-29 |
| 1053834747 | St. Catherine's Village, Inc | Skilled Nursing Facility | 200 Dominican Dr, Madison, MS 39110-8630 | 2017-07-25 |
| 1851839435 | Parker Medical Services, LLC | Skilled Nursing Facility | 1060 Lisa Ln, Terry, MS 39170-8092 | 2017-02-03 |
| 1114386687 | Genesis Healthcare | Skilled Nursing Facility | 2142 E Whitworth St, Hazlehurst, MS 39083-9277 | 2016-02-12 |
| 1003274150 | Vincent Huffstutler | Skilled Nursing Facility | 201 Mary Ellen Dr, Ripley, MS 38663-1658 | 2016-02-04 |
| 1942614219 | Adams Home Care | Skilled Nursing Facility | 225 Moore St, Pearl, MS 39208 | 2014-06-16 |
| 1861817603 | Meadowbrook Health & Rehab LLC | Skilled Nursing Facility | 211 Windmill Drive, Meridian, MS 39305 | 2014-03-04 |
| 1679819890 | Global Home Care, LLC | Skilled Nursing Facility | 4213 Pruitt Rd, West Point, MS 39773-4517 | 2012-12-14 |
| 1740526961 | Better Living Home Care, LLC | Skilled Nursing Facility | 1295 Simpson Park Rd, Weir, MS 39772-8805 | 2012-12-14 |
| 1700132065 | The Arbor | Skilled Nursing Facility | 600 S Pear Orchard Rd, Ridgeland, MS 39157-4221 | 2012-07-24 |
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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.