NPIMap

Organization Active NPI

Neshoba County General Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Philadelphia, MS
National Provider Identifier
1003946138
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
11227 Issued in MS
Legal business name
NESHOBA COUNTY GENERAL HOSPITAL
Practice address
1001 Holland Ave
Philadelphia, MS 39350-2161
Phone
(601) 663-1200
Fax
(601) 663-1379
NPI assigned
Mar 7, 2007
Last updated
Nov 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Scott McNair
Title
Cfo
Phone
(601) 663-1233

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 11227 MS Primary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X NU
Clinical Neurophysiology Physician 2084N0600X NU
EEG Specialist/Technologist 246ZE0500X NU
Sleep Medicine (Family Medicine) Physician 207QS1201X NU

Addresses

Primary practice location

1001 Holland Ave
Philadelphia, MS 39350-2161

Mailing address

PO Box 648
Philadelphia, MS 39350-0648
Phone (601) 663-1200

Other identifiers 3

IdentifierTypeStateIssuer
000019181OtherMSBLUE CROSS
450000033OtherMSMEDICARE MAMMOGRAPHY SCREENING
09013199MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040121000618 MS Part B Supplier - Clinic/Group Practice 6204738289 Receives reassigned benefits from 53 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Philadelphia, MS

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Ms Neurodiagnostic Lab16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Practitioners & affiliated clinicians

Practitioners 54

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 54

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667520000000",
    "number": "1003946138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 648",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393500648",
            "telephone_number": "601-663-1200",
            "fax_number": "601-663-1379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 HOLLAND AVE",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502161",
            "telephone_number": "601-663-1200",
            "fax_number": "601-663-1379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NESHOBA COUNTY GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A",
        "authorized_official_last_name": "MCNAIR",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "601-663-1233",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MS",
            "license": "11227",
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "246ZE0500X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, EEG",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QS1201X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sleep Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000019181",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE MAMMOGRAPHY SCREENING",
            "identifier": "450000033",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09013199",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.