VICKSBURG HEALTHCARE LLC (NPI# 1629084058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629084058 |
| 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 |
| Practice Telephone | 6018835175 |
| Practice Fax Number | 6018835197 |
| Mailing Telephone | 6018835175 |
| Mailing Fax Number | 6018835197 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2008-06-09 |
| Authorized Official Name | DEBBIE BREWER (DIRECTOR OF PROVIDER ENROLLMENT) |
| Authorized Official Telephone | 6154657000 |
| Is Organization Subpart | Y |
| Parent Organization Name | VICKSBURG HEALTHCARE LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207ZP0101X |
Pathology Specialization: Anatomic Pathology |
Allopathic & Osteopathic Physicians | ||
| N | 207ZP0105X |
Pathology Specialization: Clinical Pathology/Laboratory Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207ZC0500X |
Pathology Specialization: Cytopathology |
Allopathic & Osteopathic Physicians | ||
| N | 367500000X | Nurse Anesthetist, Certified Registered | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 367H00000X | Anesthesiologist Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00583271 | 05 | |
| LA | 1444600 | 05 |
| 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 |
| 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 |
| 1568400604 | Vicksburg Healthcare LLC | Skilled Nursing Facility | 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 | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003189416 | Vicksburg Anesthesia Services LLC | Anesthesiology | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2012-02-15 |
| 1174603799 | Hein Phan | Anesthesiology | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2006-10-17 |
| 1639259518 | Robert Clifton Strong | Anesthesiology | 1115 N Frontage Rd, Vicksburg, MS 39180-5102 | 2006-10-16 |
| 1144263823 | James William Holy | Anesthesiology | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2006-06-13 |
| 1144200387 | Larry J. Meyers | Anesthesiology | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2006-01-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306496567 | Pain Clinic Associates Pllc | Anesthesiology | 7900 Airways Blvd Ste 6, Southaven, MS 38671-4113 | 2019-09-18 |
| 1285101816 | Magnolia Anesthesia Consultants LLC | Anesthesiology | 4209 Lakeland Dr #252, Flowood, MS 39232 | 2018-11-01 |
| 1679061469 | Nuvena Vein Clinic | Anesthesiology | 120 Fountains Blvd, Madison, MS 39110 | 2018-04-26 |
| 1417309774 | North Mississippi Anesthesia Consultants Pllc | Anesthesiology | 641 N Lamar Blvd, Oxford, MS 38655-3235 | 2016-07-11 |
| 1386008332 | Robert Favret Donner | Anesthesiology | 4500 13th St Fl 2, Gulfport, MS 39501-2569 | 2016-04-06 |
| 1790145142 | Betty Bailey | Anesthesiology | 1529 Magnolia St, Lot 16, Gulfport, MS 39507-3547 | 2016-02-27 |
| 1851786628 | Chester Warren Masterson IIi | Anesthesiology | 830 S Gloster St Dept Of, Tupelo, MS 38801-4934 | 2015-03-30 |
| 1275930174 | Medical Foundation, Inc. | Anesthesiology | 1200 16th Ave, Meridian, MS 39301-4209 | 2014-11-21 |
| 1700296050 | James House Jr. | Anesthesiology | 810 Monterrey Ln, Hattiesburg, MS 39402-2437 | 2014-05-07 |
| 1487080396 | Metro Anesthesia, Pllc | Anesthesiology | 204 Valley Rd, Ridgeland, MS 39157-9105 | 2013-09-24 |
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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.