NPIMap

Organization Active NPI

North Sunflower Medical Center

  • Hospitalist Physician
  • Ruleville, MS
National Provider Identifier
1013128644
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
11-168 Issued in MS
Legal business name
NORTH SUNFLOWER MEDICAL CENTER
Practice address
840 N Oak Ave
Ruleville, MS 38771-3227
Phone
(662) 756-2711
Fax
(662) 756-4114
NPI assigned
May 25, 2007
Organization subpart
Yes
Parent organization
NORTH SUNFLOWER MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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

Authorized official

Name
Mr. Jose D Ceja
Title
Ceo
Phone
(662) 756-2711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208M00000X 11-168 MS Primary

Addresses

Primary practice location

840 N Oak Ave
Ruleville, MS 38771-3227

Mailing address

PO Box 369
Ruleville, MS 38771-0369
Phone (662) 756-2711

Other identifiers 2

IdentifierTypeStateIssuer
09013627MedicaidMS
09013432MedicaidMS

Other names 1

  • NSMC Pro Fees Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041123000318 MS Part B Supplier - Clinic/Group Practice 7618932294 Receives reassigned benefits from 109 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greenwood, MS; Ruleville, MS

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
Sunflower Greenwood Clinic19 organizations share this tax ID, including this one
Part of
Sunflower Greenwood Clinic

Other organizations with this tax ID 18

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

View all 18

Locations

102 N Ruby Ave
Ruleville, MS 38771
Phone (662) 756-0000

Practitioners & affiliated clinicians

Practitioners 104

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

View all 104

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591574400000",
    "number": "1013128644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 369",
            "city": "RULEVILLE",
            "state": "MS",
            "postal_code": "387710369",
            "telephone_number": "662-756-2711",
            "fax_number": "662-756-4114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 N OAK AVE",
            "city": "RULEVILLE",
            "state": "MS",
            "postal_code": "387713227",
            "telephone_number": "662-756-2711",
            "fax_number": "662-756-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SUNFLOWER MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH SUNFLOWER MEDICAL CENTER",
        "enumeration_date": "2007-05-25",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A",
        "authorized_official_last_name": "CEJA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-756-2711",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Hospitalist",
            "state": "MS",
            "license": "11-168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09013627",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09013432",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NSMC Pro Fees",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NSMC Pro Fees",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ruleville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; 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.