STATE OF MISSISSIPPI- UNIVERSITY OF MISSISSIPPI MEDICAL CENTER (NPI# 1841727971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841727971 |
| Entity Type | Organization |
| Organization Name | STATE OF MISSISSIPPI- UNIVERSITY OF MISSISSIPPI MEDICAL CENTER |
| Other Organization Name | HOLMES COUNTY FAMILY MEDICINE- VAIDEN |
| Practice Address |
201a Magnolia St Vaiden MS 39176-5644 |
| Practice Telephone | 6014965400 |
| Mailing Telephone | 6624965400 |
| Enumeration Date | 2017-05-19 |
| Last Update Date | 2017-05-19 |
| Authorized Official Name | MR. JEFFREY GRIMSLEY (ASST. CFO) |
| Authorized Official Telephone | 6019859181 |
| Is Organization Subpart | Y |
| Parent Organization Name | STATE OF MISSISSIPPI- UNIVERSITY OF MISSISSIPPI MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Holmes County Family Medicine- Vaiden | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285126029 | State of Mississippi- University of Mississippi Medical Center | Clinic/Center | 258 E Fortification St, Jackson, MS 39202-2356 | 2018-06-06 |
| 1689810327 | State of Mississippi- University of Mississippi Medical Center | General Acute Care Hospital | 2500 N State St, Jackson, MS 39216-4500 | 2008-12-31 |
| 1194930693 | State of Mississippi- University of Mississippi Medical Center | Clinic/Center | 350 W Woodrow Wilson Ave, Suite 479, Jackson, MS 39213-7681 | 2007-05-10 |
| Street Address |
201A MAGNOLIA ST |
| City | VAIDEN |
| State | MS |
| Zip Code | 39176-5644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053439133 | Mallory Community Health | Clinic/Center | 201a Magnolia St, Vaiden, MS 39176-5644 | 2007-03-27 |
| 1255571980 | Rava Pittman | Nurse Practitioner | 201a Magnolia St, Vaiden, MS 39176-5644 | 2009-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255757233 | Caring Hearts Home Care LLC | Nursing Care | 374 County Road 48, Vaiden, MS 39176-5047 | 2014-03-13 |
| 1144210394 | Clc of Vaiden, LLC | Skilled Nursing Facility | 868 Mulberry St, Vaiden, MS 39176-5385 | 2005-10-27 |
| 1023522448 | Courtney Williams | Occupational Therapist | 868 Mulberry St, Vaiden, MS 39176-5385 | 2017-11-21 |
| 1336520824 | Anna King | Speech-Language Pathologist | 868 Mulberry St, Vaiden, MS 39176-5385 | 2015-06-10 |
| 1023321254 | Georgianna Tappa | Occupational Therapy Assistant | 868 Mulberry St, Vaiden, MS 39176-5385 | 2010-07-16 |
| 1942513221 | Amber Shannon Joiner | Speech-Language Pathologist | 868 Mulberry St, Vaiden, MS 39176-5385 | 2010-07-15 |
| 1538411129 | Peace Wellness Center LLC | Registered Nurse | 502 Mulberry St, Vaiden, MS 39176-9648 | 2012-10-08 |
| 1770019036 | Peace Wellness Mobile Unit | Nursing Facility/Intermediate Care Facility | 502 Mulberry St, Rear Bldg, Vaiden, MS 39176-9648 | 2017-05-05 |
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730786120 | Ochsner Medical Center - Hancock, LLC | Clinic/Center | 2274 Highway 43 S Ste 200, Picayune, MS 39466-8141 | 2020-10-08 |
| 1306460282 | Covington County Hospital | Clinic/Center | 105 Eaton St, Taylorsville, MS 39168-5614 | 2020-06-05 |
| 1871117747 | Covington County Hospital | Clinic/Center | 1039 Highway 42 Ste C, Sumrall, MS 39482-4478 | 2020-06-05 |
| 1194365338 | Bounds Family Medical | Clinic/Center | 870 Main St Ste A, Fayette, MS 39069-5695 | 2020-01-15 |
| 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 |
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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.