FIELD MEMORIAL COMMUNITY HOSPITAL (NPI# 1669818480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669818480 |
| Entity Type | Organization |
| Organization Name | FIELD MEMORIAL COMMUNITY HOSPITAL |
| Other Organization Name | FMCH LIBERTY CLINIC |
| Practice Address |
1410 Main St. East Liberty MS 39645-0514 |
| Mailing Address |
Po Box 514 Liberty MS 39645-0514 |
| Practice Telephone | 6016578820 |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2019-09-12 |
| Authorized Official Name | MR. JEREMY CHAD NETTERVILLE (ADMINISTRATOR/CEO) |
| Authorized Official Telephone | 6018900545 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| FMCH Liberty Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730342643 | Field Memorial Community Hospital | Internal Medicine | 270 W Main Street, Centreville, MS 39631 | 2008-07-10 |
| 1184806747 | Field Memorial Community Hospital | Nurse Practitioner | 143 West Howard St, Centreville, MS 39631 | 2007-12-05 |
| 1134166812 | Field Memorial Community Hospital | Internal Medicine | 178 Highway 24 E Ste A, Centreville, MS 39631-4171 | 2006-06-01 |
| 1144274622 | Field Memorial Community Hospital | Family Medicine | 434 N Captain Gloster Dr, Gloster, MS 39638-3401 | 2006-05-20 |
| 1770574048 | Field Memorial Community Hospital | General Acute Care Hospital | 178 Highway 24 E, Centreville, MS 39631-4171 | 2005-11-04 |
| 1629465224 | Field Memorial Community Hospital | Internal Medicine | 178 Highway 24 E, Centreville, MS 39631-4171 | 2015-04-21 |
| 1194057943 | Field Memorial Community Hospital | Internal Medicine | 451 Bank St, Woodville, MS 39669-6000 | 2010-02-04 |
| 1023340874 | Field Memorial Community Hospital | Surgery | 260 E Main St, Centreville, MS 39631-4200 | 2010-02-04 |
| 1003148859 | Field Memorial Community Hospital | Family Medicine | 434 N Captain Gloster Dr, Gloster, MS 39638-3401 | 2010-02-04 |
| 1871633347 | Field Memorial Community Hospital | General Acute Care Hospital | 178 Highway 24 E, Centreville, MS 39631-4171 | 2007-02-07 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | FIELD MEMORIAL COMMUNITY HOSPITAL | 178 Highway 24 E, Centreville, MS 39631-4171 |
| Street Address |
1410 MAIN ST. EAST |
| City | LIBERTY |
| State | MS |
| Zip Code | 39645-0514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962563 | Cassycel Thigpen | Psychologist | 4894a Highway 584 Liberty, 4894a Highway 584 Liberty, Liberty, MS 39645 | 2020-11-05 |
| 1730566175 | John Mason Douglas | Nurse Practitioner | 102 W Freedom Dr, Liberty, MS 39645 | 2015-05-06 |
| 1407101140 | Weathers Chiropractic Center Pllc | Chiropractor | 128 West Broken St, Liberty, MS 39645 | 2012-07-18 |
| 1265646145 | Amite County School District | Registered Nurse | 3457 S. Greensburg Rd., Liberty, MS 39645 | 2007-05-09 |
| 1861428716 | Heather Johnson Harden | Nurse Practitioner | 138 Clinic Drive, Liberty, MS 39645 | 2006-06-23 |
| 1427567791 | Melanie Dawne Robertson | Nurse Practitioner | 102 W Freedom Dr, Liberty, MS 39645 | 2017-09-29 |
| 1295097269 | Karen Christine Ross | Nurse Practitioner | 102 West Freedom Drive, Liberty, MS 39645 | 2012-06-14 |
| 1528337367 | Care One Health | In Home Supportive Care | 171 East Main Street, Liberty, MS 39645 | 2011-12-23 |
| 1659693083 | Amite County Medical Services, Inc. | Clinic/Center | 102 West Freedom Drive, Liberty, MS 39645 | 2010-02-26 |
| 1639124183 | Liberty Drug Store, Inc. | Pharmacist | 110 E Main St, Liberty, MS 39645 | 2006-05-23 |
| Find all providers in zip 39645 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| 1962759837 | Reid Physician Associates, Inc | Clinic/Center | 950 N Market St, Liberty, IN 47353-8496 | 2012-08-10 |
| 1679720114 | Casey County Hospital District | Clinic/Center | 112 Liberty Sq, Liberty, KY 42539-3392 | 2008-08-27 |
| 1164598090 | Waldo County General Hospital | Clinic/Center | 43 West Main Street, Liberty, ME 04949 | 2006-11-24 |
| 1871567362 | Casey County Hospital District | Clinic/Center | 187 Wolford Ave, Liberty, KY 42539-3187 | 2006-02-14 |
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| 1720649577 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 19 Third St, Belmont, MS 38827 | 2019-06-24 |
| 1255999611 | Boa Vida Hospital of Aberdeen, Ms LLC | Clinic/Center | 400 3rd Ave 32 West, New Houlka, MS 38850 | 2019-05-31 |
| 1598238545 | South Sunflower County Hospital | Clinic/Center | 1001 West Delta, Moorhead, MS 38761 | 2019-01-02 |
| 1790272185 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 670 Ms-178, Suite 5, Sherman, MS 38869 | 2018-04-20 |
| 1124515515 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 2200 5th St N, Columbus, MS 39705-2212 | 2018-04-20 |
| 1205323698 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 815 2nd Ave N, Columbus, MS 39701-4703 | 2018-04-20 |
| Find all providers with the same taxonomy | ||||
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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.