VICKSBURG HEALTHCARE LLC (NPI# 1740228881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740228881 |
| Entity Type | Organization |
| Organization Name | VICKSBURG HEALTHCARE LLC |
| Other Organization Name | MERIT HEALTH RIVER REGION WEST |
| Practice Address |
1111 N Frontage Rd Vicksburg MS 39180-5102 |
| Mailing Address |
Po Box 841672 Dallas TX 75284-1672 |
| Practice Telephone | 6018835000 |
| Practice Fax Number | 6018833090 |
| Mailing Telephone | 6018835000 |
| Mailing Fax Number | 6018833090 |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2018-04-01 |
| Authorized Official Name | PAULA M LALOR (DIRECTOR/DELEGATED OFFICIAL) |
| Authorized Official Telephone | 6159254565 |
| Is Organization Subpart | Y |
| Parent Organization Name | VICKSBURG HEALTHCARE LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 1749079 | 05 |
| Other Name | Type Code |
|---|---|
| Merit Health River Region West | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 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 |
1111 N FRONTAGE RD |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39180-5102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255877346 | Elite Performance and Rehab, LLC | Clinic/Center | 1901 A Mission 66, Vicksburg, MS 39180 | 2017-01-12 |
| 1679931083 | Heather M Anderson | Physician Assistant | 2080 S Frontage Rd Ste 100, Vicksburg, MS 39180 | 2016-02-01 |
| 1245604941 | Warren County Assn.for Retarded Citizens, Inc. | Day Training, Developmentally Disabled Services | 100 Smokey Lane, Vicksburg, MS 39180 | 2015-11-18 |
| 1386012904 | Brian Oliver Snowden | Counselor | 3530 Manor Dr Ste 5a, Vicksburg, MS 39180 | 2015-09-14 |
| 1962802710 | Jordan P. Crocker, D.m.d., Pllc | Clinic/Center | 109 Monument Place, Vicksburg, MS 39180 | 2014-08-29 |
| 1821434259 | Trisha Addison | Physical Therapist | 2222 South Frontage Road, Suite D, Vicksburg, MS 39180 | 2013-05-13 |
| 1073862157 | Laura Jeanne Briggs | Physical Therapist | 1901-a Mission 66, Vicksburg, MS 39180 | 2012-09-05 |
| 1912175258 | Andrea T. Harris | Counselor | Warren-yazoo Mental Health Service, 3444 Wisconsin Ave., Vicksburg, MS 39180 | 2008-02-20 |
| 1922217314 | Austin Family Dentistry | Dentist | 3040 Indiana Ave, Vicksburg, MS 39180 | 2007-05-22 |
| 1063539138 | Ollie Hardaway Jr. | Dentist | 154 Cottonwood Street, Vicksburg, MS 39180 | 2007-03-23 |
| Find all providers in zip 39180 | ||||
| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407269756 | East Mississippi State Hospital | Psychiatric Unit | 1401 College Dr, Meridian, MS 39307-5345 | 2014-06-04 |
| 1699803395 | Walter Robert Jones Jr. | Psychiatric Unit | Hwy 468, Hudspeth Regional Center, Whitfield, MS 39193 | 2007-03-02 |
| 1306803481 | George County Hospital | Psychiatric Unit | 859 Winter Steet, Lucedale, MS 39452-6603 | 2006-05-01 |
| 1457330995 | South Mississippi State Hospital | Psychiatric Unit | 823 Highway 589, Purvis, MS 39475-4194 | 2006-01-12 |
| 1831184951 | Alliance Health Center Inc | Psychiatric Unit | 5000 Highway 39 N, Meridian, MS 39301-1021 | 2005-09-14 |
| 1801414115 | Singing River Gulfport | Psychiatric Unit | 15200 Community Rd, Gulfport, MS 39503-3085 | 2020-07-13 |
| 1679036313 | Progressive Medical Management of Batesville LLC | Psychiatric Unit | 155 Keating Rd, Batesville, MS 38606-2901 | 2019-04-10 |
| 1689191629 | Boa Vida Hospital of Aberdeen, Ms, LLC | Psychiatric Unit | 400 S Chestnut St, Aberdeen, MS 39730-3335 | 2017-08-29 |
| 1033643937 | Batesville Regional Medical Center, Inc. | Psychiatric Unit | 303 Medical Center Dr, Batesville, MS 38606-8608 | 2017-04-18 |
| 1801329834 | Lifebrite Hospital Group of Aberdeen LLC | Psychiatric Unit | 400 S Chestnut St, Aberdeen, MS 39730-3335 | 2017-04-06 |
| 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.