SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.


Address: 1179 Highway 42, Petal, MS 39465-9740
Phone: 6015458700

SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC. (NPI# 1932446051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1932446051
Entity Type Organization
Organization Name SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.
Other Organization Name PETAL ELEMENTARY SCHOOL
Practice Address 1179 Highway 42
Petal
MS 39465-9740
Mailing Address Po Box 1729
Hattiesburg
MS 39403-1729
Practice Telephone 6015458700
Practice Fax Number 6014502493
Mailing Telephone 6015458700
Mailing Fax Number 6014502493
Enumeration Date 2013-01-09
Last Update Date 2017-08-14
Authorized Official Name GEROLDEAN DYSE (CEO)
Authorized Official Telephone 6015458700
Is Organization Subpart Y
Parent Organization Name SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QF0400X Clinic/Center
Specialization: Federally Qualified Health Center (FQHC)
MS Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
MS 05782753 05

Other Provider/Organization Names

Other Name Type Code
Petal Elementary School Other Name - Individual/Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1407363559 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 215 Old Highway 49 E, Brooklyn, MS 39425-9028 2018-01-10
1952814469 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 64 Old Airport Rd, Hattiesburg, MS 39401-8382 2017-11-07
1053862524 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 104 Carver Drive, Collins, MS 39428 2016-10-20
1477004463 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 824 Hopewell Rd, Collins, MS 39428-5736 2016-10-14
1942751938 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 1208 Dogwood Ave, Collins, MS 39428-4160 2016-10-14
1457800146 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 301 South 4th Street, Mount Olive, MS 39119-0000 2016-09-23
1497202527 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 401 Dogwood Street, Collins, MS 39428-0000 2016-09-07
1184961153 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 60 Herrington Rd, Petal, MS 39465-8842 2013-01-11
1427328889 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 301 Hutchinson Ave, Hattiesburg, MS 39401-4134 2012-01-03
1265461719 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 100 W Front St, Hattiesburg, MS 39401-3460 2006-06-30

Office Location

Street Address 1179 HIGHWAY 42
City PETAL
State MS
Zip Code 39465-9740

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1164055489 R&p Elite Services, LLC Private Vehicle 68 Springfield Rd., Petal, MS 39465 2020-02-14
1003460544 Hayden White Pharmacist 36 Byrd Dr., Petal, MS 39465 2019-08-01
1134612971 Chandler Mccarley Hawkins Dentist 1115 Evelyn Gandy Parkway, Petal, MS 39465 2018-06-06
1881199818 Lauren O'neal Garner Nurse Practitioner 36 Stadium Drive, Petal, MS 39465 2018-03-30
1700036928 Petal School District Registered Nurse 60 Herrington Road, Petal, MS 39465 2008-09-24
1962679043 Hattiesburg Eye Clinic Pa Optometrist 1223 Hwy 42, Ste 140, Petal, MS 39465 2008-05-08
1023228640 Noal Baxter Cochran Marriage & Family Therapist 80 Lakeland Circle, Petal, MS 39465 2007-05-23
1750596938 James A Nicholson Dds Pa Dentist 120 South 28th Avenue, Hattiesburg, MS 39465 2007-05-11
1356563605 Petal School District Registered Nurse 400 Hillcrest Loop, Petal, MS 39465 2007-05-03
1154480804 Mary E Thomsen Orthotic Fitter 173 Cherry Oak Trail, Petal, MS 39465 2006-12-08
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Taxonomy Information

Taxonomy Code 261QF0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Federally Qualified Health Center (FQHC)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1720327919 Southeast Mississippi Rural Health Initiative, Inc Clinic/Center 203 Highway 42, Petal, MS 39465-2864 2013-02-07
1184961153 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 60 Herrington Rd, Petal, MS 39465-8842 2013-01-11
1225073968 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 9214 Highway 42, Petal, MS 39465-8604 2006-06-17
1952724650 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 36 Panther Stadium Dr, Petal, MS 39465-3632 2014-01-31
1003153073 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 1145 Highway 42, Petal, MS 39465-9740 2013-01-11
1821335894 Southeast Mississippi Rural Health Initiative, Inc. Clinic/Center 400 Hillcrest Loop, Petal, MS 39465-2634 2013-01-11

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1871193722 Coastal Family Health Center, Inc Clinic/Center 12424 Highway 57, Vancleave, MS 39565-8608 2020-10-29
1992305445 Coastal Family Health Center, Inc Clinic/Center 5500 Hurley Wade Rd, Moss Point, MS 39562-8548 2020-10-26
1841890399 Coastal Family Health Center, Inc Clinic/Center 10700 Yellow Jacket Rd, Ocean Springs, MS 39564-8038 2020-10-26
1033755343 Access Family Health Services, Inc. Clinic/Center 179 Mullen Ave, Nettleton, MS 38858-6033 2019-11-21
1285280180 Delta Health Center, Inc Clinic/Center 506 Washington Avenue, Moorhead, MS 38761 2019-08-15
1265088421 Delta Health Center, Inc Clinic/Center 400 South Blvd, Drew, MS 38737-3508 2019-08-14
1215583356 Delta Health Center, Inc. Clinic/Center 302 College Ave, Indianola, MS 38751-2112 2019-08-14
1063068252 Delta Health Center, Inc Clinic/Center 1101 Oak St, Inverness, MS 38753-8725 2019-08-13
1750937959 Delta Health Center, Inc Clinic/Center 212 E Claiborne St, Sunflower, MS 38778-9640 2019-08-13
1750937108 Delta Health Center, Inc Clinic/Center 410 L F Packer Dr, Ruleville, MS 38771-3604 2019-08-12
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Competitor

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City PETAL
Zip Code 39465

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Dataset Information

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.

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