NPIMap

Sharkey Issaquena Community Hospital

Organization Active NPI General Acute Care Hospital · Rolling Fork, MS

NPI 1013004795 · NPPES record last updated Jun 23, 2026

Key facts

NPI
1013004795
Entity type
Organization (NPI type 2)
Primary specialty
General Acute Care Hospital 282N00000X
License
21-172 (MS)
Legal business name
SHARKEY ISSAQUENA COMMUNITY HOSPITAL
Practice address
47 S Fourth St
Rolling Fork, MS 39159-5146
Phone
(662) 873-4395
Fax
(662) 873-5188
NPI assigned
Oct 6, 2006
Organization subpart
No

Authorized official

Name
Mr. Steven Gerald Keever
Title
Administrator
Phone
(662) 873-4395

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 2

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

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 16

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare Care Compare: Hospital

Listed as
Sharkey Issaquena Community Hospital CCN 250784
Type
Rural Emergency Hospital
Ownership
Government - Local
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MS

Hospital certification: CCN 250784

Legal name
SHARKEY ISSAQUENA COMMUNITY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Rural emergency hospital
Participating since
May 1, 2024
Last certification
Feb 27, 2025
Beds
1
Ownership / control type
Local
Organization structure
Other · Non-profit
Enrollment address
47 S Fourth St
Rolling Fork, MS 39159-5146
Other Hospital Practice Location

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Steven G Keever
Individual 		Corporate Director Nov 24, 2008
W-2 Managing Employee
Ceo		 Aug 29, 2002

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Sharkey Issaquena Nursing Home
Rolling Fork, MS · CCN 255220		 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2016
Jan 1, 2016
Sharkey Issaquena Community Hospital
Rolling Fork, MS · CCN 258672		 Rural health clinic 5% Or Greater Direct Ownership Interest Jan 1, 1966

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040126000869 MS Part B Supplier - Clinic/Group Practice 1759283039 Receives reassigned benefits from 19 practitioners
2 other NPIs on this enrollment
Practice locations: Rolling Fork, MS
O20240319000608 MS Part a Provider - Rural Emergency Hospital (Reh) 1759283039 Practice locations: Rolling Fork, MS

National Provider Directory

Locations

19719 Highway 61
Rolling Fork, MS 39159
Phone (662) 873-4395

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 21-172 MS Yes
Rural Acute Care Hospital 282NR1301X

Addresses

Primary practice location

47 S Fourth St
Rolling Fork, MS 39159-5146

Mailing address

PO Box 339
Rolling Fork, MS 39159-0339
Phone (662) 873-4395

Other identifiers

IdentifierTypeStateIssuer
9013019MedicaidMS
9013018MedicaidMS
0020129MedicaidMS
20129OtherMSBLUE CROSS BLUE SHIELD
0050033MedicaidMS
0029129MedicaidMS

Other providers in Rolling Fork, MS

All providers in Rolling Fork, MS · General Acute Care Hospital in Mississippi

Sources for this page

Verify at the official NPI Registry.