VICKSBURG HEALTHCARE LLC (NPI# 1639799430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639799430 |
| Entity Type | Organization |
| Organization Name | VICKSBURG HEALTHCARE LLC |
| Practice Address |
2100 Highway 61 N Vicksburg MS 39183-8211 |
| Mailing Address |
Po Box 841672 Dallas TX 75284-1672 |
| Practice Telephone | 6018835000 |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2020-04-21 |
| Authorized Official Name | JAMES P WRIGHT (VP PHYSICIAN BUSINESS SERVICES) |
| Authorized Official Telephone | 6157781502 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| Other Name | Type Code |
|---|---|
| Merit Health River Region | 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 |
| 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 |
| 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 |
| 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 |
| 1073960647 | Andrew Hendrix | Registered Nurse | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2016-05-24 |
| 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 | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427195882 | Vicksburg Pathology Laboratory | Clinical Medical Laboratory | 1911 Mission 66, Vicksburg, MS 39180-3762 | 2007-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457952855 | Boston Labs, LLC | Clinical Medical Laboratory | 631 Lakeland East Dr Ste 203, Flowood, MS 39232-8815 | 2020-11-03 |
| 1023622305 | Molecular and Diagnostic Testing Labs of America | Clinical Medical Laboratory | 1529 Cliff Gookin Blvd, Tupelo, MS 38801-6401 | 2020-09-03 |
| 1134742505 | Temeka Denson | Clinical Medical Laboratory | 104 Meadow Hill Dr, Forest, MS 39074-3817 | 2020-05-20 |
| 1225675531 | Wellcare Labs, LLC | Clinical Medical Laboratory | 1270 28th St, Gulfport, MS 39501-6205 | 2019-12-05 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1457810137 | Dynamic Diagnostics LLC | Clinical Medical Laboratory | 10203 Highway 603, Bay St Louis, MS 39520-8711 | 2019-03-13 |
| 1134699945 | Executive Diagnostics LLC | Clinical Medical Laboratory | 5455 Executive Pl Ste B, Jackson, MS 39206-4104 | 2018-12-05 |
| 1699287300 | Metric Lab Services LLC | Clinical Medical Laboratory | 116 Marketridge Dr, Ridgeland, MS 39157-6009 | 2017-11-03 |
| 1336660786 | Vitas Laboratory LLC | Clinical Medical Laboratory | 2048 Pineville Road, Suite B, Long Beach, MS 39560 | 2017-07-06 |
| 1275073405 | Marvel Laboratories, LLC | Clinical Medical Laboratory | 805 W Park Ave, Suite 5a, Greenwood, MS 38930-2832 | 2017-03-07 |
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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.