NPIMap

Organization Active NPI

Stone County Hospital, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Wiggins, MS
National Provider Identifier
1073758975
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
12-280 Issued in MS
Legal business name
STONE COUNTY HOSPITAL, INC
Practice address
1434 Central Ave E
P O Drawer 97
Wiggins, MS 39577-9602
Phone
(601) 928-6600
Fax
(601) 928-6658
NPI assigned
Dec 5, 2008
Last updated
Jun 9, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

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

Authorized official

Name
Darlene C Odom
Title
Managed Care
Phone
(601) 928-5999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 12-280 MS Primary

Addresses

Primary practice location

1434 Central Ave E
P O Drawer 97
Wiggins, MS 39577-9602

Mailing address

1434 Central Ave E
Wiggins, MS 39577-9602
Phone (601) 928-6600

Other identifiers 2

IdentifierTypeStateIssuer
25Z303OtherMSSWINGBED
00220720MedicaidMS

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1228435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465430400000",
    "number": "1073758975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1434 CENTRAL AVE E",
            "city": "WIGGINS",
            "state": "MS",
            "postal_code": "395779602",
            "telephone_number": "601-928-6600",
            "fax_number": "601-928-6658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1434 CENTRAL AVE E",
            "address_2": "P O DRAWER 97",
            "city": "WIGGINS",
            "state": "MS",
            "postal_code": "395779602",
            "telephone_number": "601-928-6600",
            "fax_number": "601-928-6658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONE COUNTY HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-05",
        "last_updated": "2016-06-09",
        "status": "A",
        "authorized_official_last_name": "ODOM",
        "authorized_official_first_name": "DARLENE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGED CARE",
        "authorized_official_telephone_number": "601-928-5999"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "MS",
            "license": "12-280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SWINGBED",
            "identifier": "25Z303",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00220720",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wiggins, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; 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.