SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER (NPI# 1700962362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700962362 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER |
| Other Organization Name | SW MS REG MED CTR CRNA |
| Practice Address |
215 Marion Ave Mccomb MS 39648-2705 |
| Mailing Address |
215 Marion Ave P O Box 1307 Mccomb MS 39648-2705 |
| Practice Telephone | 6012495500 |
| Practice Fax Number | 6012491696 |
| Mailing Telephone | 6012495500 |
| Mailing Fax Number | 6012491696 |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | MR. PHILIP PANDOLPH (COO) |
| Authorized Official Telephone | 6012491882 |
| Is Organization Subpart | Y |
| Parent Organization Name | SW MS REG MED CTR CRNA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09013416 | 05 |
| Other Name | Type Code |
|---|---|
| SW MS REG MED CTR CRNA | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700344066 | Southwest Mississippi Regional Medical Center | Surgery | 1065 E Broad St., Monticello, MS 39654 | 2019-03-06 |
| 1013107473 | Southwest Mississippi Regional Medical Center | Orthopaedic Surgery | 510a Highway 51 N, Brookhaven, MS 39601-2335 | 2007-07-31 |
| 1649386061 | Southwest Mississippi Regional Medical Center | Urology | 1015 Delaware Ave Ste B, Mccomb, MS 39648-3827 | 2006-08-21 |
| 1932159498 | Southwest Mississippi Regional Medical Center | Internal Medicine | 300 Rawls Dr Ste 200, Mccomb, MS 39648-2871 | 2006-05-12 |
| 1861442873 | Southwest Mississippi Regional Medical Center | Clinic/Center | 28 Bogue Chitto Rd Sw, Bogue Chitto, MS 39629-9488 | 2006-05-11 |
| 1689624090 | Southwest Mississippi Regional Medical Center | Internal Medicine | 300 Marion Ave, Suite C, Mccomb, MS 39648-2707 | 2006-05-10 |
| 1245289172 | Southwest Mississippi Regional Medical Center | Clinic/Center | 1167 E Broad St, Monticello, MS 39654-7682 | 2006-05-08 |
| 1366066060 | Southwest Mississippi Regional Medical Center | Clinic/Center | 300 Rawls Dr Ste 1500, Mccomb, MS 39648-2878 | 2020-05-29 |
| 1932721222 | Southwest Mississippi Regional Medical Center | Internal Medicine | 1065 E Broad St, Monticello, MS 39654-7703 | 2020-05-11 |
| 1144873910 | Southwest Mississippi Regional Medical Center | Obstetrics & Gynecology | 1318 Harrison Ave, Mccomb, MS 39648-2830 | 2019-07-22 |
| Street Address |
215 MARION AVE |
| City | MCCOMB |
| State | MS |
| Zip Code | 39648-2705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699759704 | Ronald Jack Morgan | Family Medicine | 215 Marion Ave, Mccomb, MS 39648 | 2005-12-01 |
| 1831799022 | Carrie Lee Fernald | Nurse Practitioner | 215 Marion Ave, Mccomb, MS 39648-2705 | 2020-10-28 |
| 1366082778 | Malinda F Donald | Nurse Practitioner | 215 Marion Ave, Mccomb, MS 39648-2705 | 2020-01-14 |
| 1477195972 | Relias Emergency Medicine Specialists of Mccomb, LLC | Emergency Medicine | 215 Marion Ave, Mccomb, MS 39648-2705 | 2019-10-16 |
| 1962968040 | John Mark Irby | Nurse Practitioner | 215 Marion Ave, Mccomb, MS 39648-2705 | 2019-02-14 |
| 1326524869 | Jarrod P Fontenelle | Nurse Anesthetist, Certified Registered | 215 Marion Ave, Mccomb, MS 39648-2705 | 2018-07-18 |
| 1326556424 | Will G. Stevens | Nurse Anesthetist, Certified Registered | 215 Marion Ave, Mccomb, MS 39648-2705 | 2018-01-11 |
| 1871013615 | Southwest Mississippi Regional Medical Center | Obstetrics & Gynecology | 215 Marion Ave, Mccomb, MS 39648-2705 | 2017-06-22 |
| 1225578396 | Megan Jackson Jarancik | Nurse Practitioner | 215 Marion Ave, Mccomb, MS 39648-2705 | 2017-03-08 |
| 1720530298 | Proxsys Rx - Rush LLC | Pharmacy | 215 Marion Ave, Suite 200, Mccomb, MS 39648-2705 | 2016-10-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952910366 | Ct Stamps Inc | Pharmacy | 206 Marion Avenue, Mccomb, MS 39648 | 2020-07-31 |
| 1952910457 | Fresenius Medical Care East Mccomb Dialysis, LLC | Clinic/Center | 103 Business Center Drive, Mccomb, MS 39648 | 2020-07-30 |
| 1902423312 | Joseph Edward Mingo II | Counselor | 513 Lee St, Mccomb, MS 39648 | 2020-07-01 |
| 1427608769 | Benda Truvillion | Technician | 2128 Park Dr. Ext., Mccomb, MS 39648 | 2019-09-18 |
| 1295228187 | Edna Ruth Winston | Counselor | Sw Ms Mental Health Complex, 1701 White St, Mccomb, MS 39648 | 2018-06-14 |
| 1386153450 | Sholitha Nunnery | Counselor | 502 North Cherry Street, Mccomb, MS 39648 | 2017-09-21 |
| 1548600612 | Jordan Harrington | Nurse Practitioner | 303 Marion Ave., Mccomb, MS 39648 | 2013-07-03 |
| 1891096236 | Zwound Care | Family Medicine | 1126 Country Club Road, Mccomb, MS 39648 | 2010-11-16 |
| 1588891717 | Kelly Edmondson | Physical Therapy Assistant | 1301a Harrison Ave, Mccomb, MS 39648 | 2009-06-15 |
| 1962647651 | Gwendolyn Michelle Brown | Home Health Aide | 1114 1/2 Venable St., Mccomb, MS 39648 | 2008-12-09 |
| Find all providers in zip 39648 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (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. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063709418 | George Rayford Smith II | Nurse Anesthetist, Certified Registered | 215 Marion Dr., Mccomb, MS 39648-4040 | 2011-07-06 |
| 1326524869 | Jarrod P Fontenelle | Nurse Anesthetist, Certified Registered | 215 Marion Ave, Mccomb, MS 39648-2705 | 2018-07-18 |
| 1326556424 | Will G. Stevens | Nurse Anesthetist, Certified Registered | 215 Marion Ave, Mccomb, MS 39648-2705 | 2018-01-11 |
| 1497138598 | Elise Reeves | Nurse Anesthetist, Certified Registered | 215 Marion Ave, Mccomb, MS 39648-2705 | 2015-07-07 |
| 1073818449 | Rachel Spiers | Nurse Anesthetist, Certified Registered | 215 Marion Ave, Mccomb, MS 39648-2705 | 2011-01-17 |
| 1205073996 | Irby Lee Campbell | Nurse Anesthetist, Certified Registered | 215 Marion Ave, Mccomb, MS 39648-2705 | 2009-01-16 |
| 1952563041 | Derek Gavin Davis | Nurse Anesthetist, Certified Registered | 215 Marion Ave, Mccomb, MS 39648-2705 | 2008-06-30 |
| 1861653941 | Tiffiney L Lavergne | Nurse Anesthetist, Certified Registered | 215 Marion Ave, Mccomb, MS 39648-2705 | 2008-06-20 |
| 1902989700 | Christina Rayburn Fortenberry | Nurse Anesthetist, Certified Registered | 215 Marion Ave, Mccomb, MS 39648-2705 | 2006-10-23 |
| 1164523973 | Wayne Leland Johnson | Nurse Anesthetist, Certified Registered | 215 Marion Ave, Mccomb, MS 39648-2705 | 2006-09-26 |
| Find all providers in MCCOMB | ||||
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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.