NPIMap

Organization Active NPI

Ms Band of Choctaw Indians

Doing business as Dba Choctaw Health Center Women's Wellness

  • Case Manager/Care Coordinator
  • Choctaw, MS
National Provider Identifier
1053633230
Registry record updated Jun 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Legal business name
MS BAND OF CHOCTAW INDIANS
Doing business as
Dba Choctaw Health Center Women's Wellness
Practice address
210 Hospital Cir
Choctaw, MS 39350-6781
Phone
(601) 656-2211
Fax
(601) 663-7721
NPI assigned
Feb 16, 2010
Last updated
Jun 15, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2012

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

Authorized official

Name
Mrs. Phyllis J Anderson
Title
Tribal Chief
Phone
(601) 656-2211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

210 Hospital Cir
Choctaw, MS 39350-6781

Mailing address

210 Hospital Cir
Choctaw, MS 39350-6781
Phone (601) 656-2211

Other identifiers 1

IdentifierTypeStateIssuer
09013321MedicaidMS

Other names 1

  • DBA CHOCTAW HEALTH CENTER WOMEN'S WELLNESS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ms Band of Choctaw Indians10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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": "1266278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339718400000",
    "number": "1053633230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 HOSPITAL CIR",
            "city": "CHOCTAW",
            "state": "MS",
            "postal_code": "393506781",
            "telephone_number": "601-656-2211",
            "fax_number": "601-663-7721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 HOSPITAL CIR",
            "city": "CHOCTAW",
            "state": "MS",
            "postal_code": "393506781",
            "telephone_number": "601-656-2211",
            "fax_number": "601-663-7721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MS BAND OF CHOCTAW INDIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-16",
        "last_updated": "2012-06-15",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "TRIBAL CHIEF",
        "authorized_official_telephone_number": "601-656-2211",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09013321",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA CHOCTAW HEALTH CENTER WOMEN'S WELLNESS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Choctaw, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; 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.