NPIMap

Organization Active NPI

Sharkey Issaquena Comm Hospital - Radiology

  • Radiology Clinic/Center
  • Rolling Fork, MS
National Provider Identifier
1013217074
Registry record updated Oct 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
SHARKEY ISSAQUENA COMM HOSPITAL - RADIOLOGY
Practice address
47 S Fourth St
Rolling Fork, MS 39159-5146
Phone
(662) 873-5171
Fax
(662) 873-5194
NPI assigned
Oct 25, 2010
Last updated
Oct 25, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2010

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

Authorized official

Name
Kimberly Loreto
Title
Director His / Business Office
Phone
(662) 873-5171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X NU Primary

Addresses

Primary practice location

47 S Fourth St
Rolling Fork, MS 39159-5146

Mailing address

47 S Fourth St
Rolling Fork, MS 39159-5146
Phone (662) 873-5171

Other identifiers 1

IdentifierTypeStateIssuer
09013318MedicaidMS

National Provider Directory

National Provider Directory
Tax ID family
Sharkey Issaquena Comm Hosp-ER7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287964800000",
    "number": "1013217074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 S FOURTH ST",
            "city": "ROLLING FORK",
            "state": "MS",
            "postal_code": "391595146",
            "telephone_number": "662-873-5171",
            "fax_number": "662-873-5194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 S FOURTH ST",
            "city": "ROLLING FORK",
            "state": "MS",
            "postal_code": "391595146",
            "telephone_number": "662-873-5171",
            "fax_number": "662-873-5194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHARKEY ISSAQUENA COMM HOSPITAL - RADIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-25",
        "last_updated": "2010-10-25",
        "status": "A",
        "authorized_official_last_name": "LORETO",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "DIRECTOR HIS / BUSINESS OFFICE",
        "authorized_official_telephone_number": "662-873-5171"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09013318",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolling Fork, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.