NPIMap

Organization Active NPI

Anderson Regional Medical Center

Doing business as Anderson Regional Medical Center South Campus

  • Anesthesiology Physician
  • Meridian, MS
National Provider Identifier
1073759494
Registry record updated Aug 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ANDERSON REGIONAL MEDICAL CENTER
Doing business as
Anderson Regional Medical Center South Campus
Practice address
1102 Constitution Ave
Meridian, MS 39301-4001
Phone
(601) 553-6647
Fax
(601) 553-6115
NPI assigned
Jan 7, 2009
Last updated
Aug 5, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2013

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

Authorized official

Name
Mr. Keith Heartsill
Title
Cfo
Phone
(601) 553-6104

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

1102 Constitution Ave
Meridian, MS 39301-4001

Mailing address

2124 14TH St
Meridian, MS 39301-4040
Phone (601) 553-6000

Other names 1

  • Anderson Regional Medical Center South Campus Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031117000522 MS Part B Supplier - Clinic/Group Practice 4284548025 Receives reassigned benefits from 40 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Enterprise, MS; Philadelphia, MS; Meridian, 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

Locations

83A Old Mill Creek Rd
Enterprise, MS 39330
Phone (601) 704-1020

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375660800000",
    "number": "1073759494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 14TH ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014040",
            "telephone_number": "601-553-6000",
            "fax_number": "601-553-6848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 CONSTITUTION AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014001",
            "telephone_number": "601-553-6647",
            "fax_number": "601-553-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-07",
        "last_updated": "2013-08-05",
        "status": "A",
        "authorized_official_last_name": "HEARTSILL",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "601-553-6104",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anderson Regional Medical Center South Campus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Meridian, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2013; 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.