LEAKE COUNTY BOARD OF TRUSTEES (NPI# 1831174804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831174804 |
| Entity Type | Organization |
| Organization Name | LEAKE COUNTY BOARD OF TRUSTEES |
| Other Organization Name | LEAKE MEMORIAL HOSPITAL |
| Practice Address |
310 Ellis St Carthage MS 39051-3809 |
| Practice Telephone | 6012671100 |
| Practice Fax Number | 6012671211 |
| Mailing Telephone | 6012671100 |
| Mailing Fax Number | 6012671211 |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2008-12-30 |
| Authorized Official Name | MR. ROBERT DANIEL FAULKNER (ADMINISTRATOR) |
| Authorized Official Telephone | 6012671432 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 282N00000X | General Acute Care Hospital | 11-187 | MS | Hospitals |
| N | 282NR1301X |
General Acute Care Hospital Specialization: Rural |
11-187 | MS | Hospitals |
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
11-187 | MS | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 9016253 | 05 | |
| MS | 0220808 | 05 | |
| MS | 0220809 | 05 | |
| MS | 0230186 | 05 | |
| MS | 9016232 | 05 |
| Other Name | Type Code |
|---|---|
| Leake Memorial Hospital | Doing Business As Name - Organization |
| Street Address |
310 ELLIS ST |
| City | CARTHAGE |
| State | MS |
| Zip Code | 39051-3809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245684612 | Leake Ltc, LLC | Nursing Facility/Intermediate Care Facility | 310 Ellis St, Carthage, MS 39051-3809 | 2016-04-21 |
| 1720336126 | Baptist Medical Center -leake Inc | Hospitalist | 310 Ellis St, Carthage, MS 39051-3809 | 2012-08-16 |
| 1588940811 | Baptist-leake Extended Care Facility | Nursing Facility/Intermediate Care Facility | 310 Ellis St, Carthage, MS 39051-3809 | 2011-11-01 |
| 1891832747 | William D Logan Jr. | Emergency Medicine | 310 Ellis St, Carthage, MS 39051-3809 | 2007-01-31 |
| 1750456034 | Leake Extended Care Facility | Nursing Facility/Intermediate Care Facility | 310 Ellis St, Carthage, MS 39051-3809 | 2006-11-21 |
| 1023187689 | Tommie K Jones | Nurse Practitioner | 310 Ellis St, Carthage, MS 39051-3809 | 2006-11-07 |
| 1073545554 | Evan J. Pickus | Emergency Medicine | 310 Ellis St, Carthage, MS 39051-3809 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598275828 | Roots Healthcare and Homes, LLC | Meals | 292 Pickens Circle, Carthage, MS 39051 | 2017-09-30 |
| 1427575505 | Trend Health and Rehab of Carthage | Skilled Nursing Facility | 1101 E. Franklin Street, Carthage, MS 39051 | 2017-08-29 |
| 1750738415 | Telehealthone LLC | Nurse Practitioner | 300 South Pearl Street, Carthage, MS 39051 | 2016-05-23 |
| 1316297575 | Silver Lining Adult Daycare, LLC | Respite Care | 531 Highway 35 North, Carthage, MS 39051 | 2012-09-14 |
| 1508179888 | Mississippi Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 205 Highway 16 West, Carthage, MS 39051 | 2010-07-15 |
| 1376725754 | Amye L Shamburger | Dentist | 101 S. Pearl Street, Carthage, MS 39051 | 2007-11-28 |
| 1770786188 | Carthage Eye Clinic Pa | Optometrist | 201 Hwy 16 East, Carthage, MS 39051 | 2007-06-06 |
| 1265553762 | David C Henderson | Dentist | 113 North Pearl St, Carthage, MS 39051 | 2007-04-02 |
| 1780722280 | Linda N Roland | Nurse Practitioner | 204 Chipley St., Carthage, MS 39051 | 2007-02-05 |
| 1205914298 | William M Myers II | Dentist | 12646 Hwy 488, Carthage, MS 39051 | 2006-11-01 |
| Find all providers in zip 39051 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730139031 | Memorial Hospital Association | General Acute Care Hospital | 1454 N County Road 2050, Carthage, IL 62321-3551 | 2006-05-10 |
| 1104234376 | Carthage Area Hospital, Inc. | General Acute Care Hospital | 1001 West St, Carthage, NY 13619-9703 | 2014-07-31 |
| 1073858262 | Memorial Hospital Association | General Acute Care Hospital | 1454 N County Road 2050, Carthage, IL 62321-3551 | 2012-11-29 |
| 1396012753 | Mercy Hospital Carthage | General Acute Care Hospital | 3125 Dr Russell Smith Way, Carthage, MO 64836-7402 | 2011-11-29 |
| 1205112539 | Baptist Medical Center-leake Inc | General Acute Care Hospital | 1100 Hwy 16 East, Carthage, MS 39051 | 2011-11-01 |
| 1104137215 | Riverview Medical Center LLC | General Acute Care Hospital | 158 Hospital Dr, Carthage, TN 37030-1083 | 2010-06-24 |
| 1932355625 | Memorial Hospital Association | General Acute Care Hospital | 402 S Adams St, Carthage, IL 62321-1600 | 2008-08-13 |
| 1790860575 | Mccune-brooks Hospital | General Acute Care Hospital | 3125 Dr Russell Smith Way, Carthage, MO 64836-7402 | 2006-10-27 |
| 1629082466 | Frank T Rutherford Memorial Hospital, Inc | General Acute Care Hospital | 130 Lebanon Hwy, Carthage, TN 37030-2955 | 2006-07-28 |
| 1801814629 | Frank T Rutherford Memorial Hospital, Inc | General Acute Care Hospital | 130 Lebanon Hwy, Carthage, TN 37030-2955 | 2006-07-18 |
| Find all providers in CARTHAGE | ||||
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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.