Active NPI
Southeast Mississippi Rural Health Initiative, Inc.
- Federally Qualified Health Center (FQHC)
- Collins, MS
National Provider Identifier
1053862524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.
- Practice address
- 104 Carver Drive
Collins, MS 39428 - Phone
- (601) 545-8700
- Fax
- (601) 450-2493
- NPI assigned
- Oct 20, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Kaye Ray
- Title
- Ceo
- Phone
- (601) 545-8700
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Primary |
Addresses
Primary practice location
104 Carver Drive
Collins, MS 39428
Mailing address
PO Box 1729
Hattiesburg, MS 39403-1729
Phone (601) 545-8700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02236381 | Medicaid | MS |
Other names 1
- Carver Middle School
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Federally qualified health center certification: CCN 251044
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- CARVER MIDDLE SCHOOL
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Mar 27, 2017
- Last certification
- Mar 27, 2017
- Ownership / control type
- For profit – corporation
- Facility address
- 104 Carver Drive
Collins, MS 39428
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476921600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1662422400000",
"number": "1053862524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1729",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394031729",
"telephone_number": "601-545-8700",
"fax_number": "601-450-2493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 CARVER DRIVE",
"city": "COLLINS",
"state": "MS",
"postal_code": "39428",
"telephone_number": "601-545-8700",
"fax_number": "601-450-2493"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2016-10-20",
"last_updated": "2022-09-06",
"certification_date": "2022-09-06",
"status": "A",
"authorized_official_last_name": "RAY",
"authorized_official_first_name": "KAYE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "601-545-8700",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02236381",
"state": "MS"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Carver Middle School",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "Carver Middle School",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Collins, MS
- Hayley Rae Evelyn Schmidtberger, DPT
- Shepherd Hearing Center LLC
- Kyle Robert Shepherd, HIS
- James Harold Shivers II, FNP
- Harpreet Singh Sood, MD
- Southeast Mississippi Rural Health Initiative, Inc.
- Southeast Mississippi Rural Health Initiative, Inc.
- Southeast Mississippi Rural Health Initiative, Inc.
- Southern Bone & Joint Specialists, PA
- Southern Family Medicine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.