Pioneer Health Services of Monroe County, Inc

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

PIONEER HEALTH SERVICES OF MONROE COUNTY, INC

Doing business as

Chestnut Medical Clinic

Practice address

500 S Chestnut St
Aberdeen, MS 39730-3337

Phone

(601) 369-9525

NPI assigned

Jun 15, 2006

Last updated

Jun 2, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Joseph S McNulty III, CRT

Title

President

Phone

(691) 849-4112

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Chestnut Medical Clinic Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Boa Vida Hospital of Aberdeen, Ms, LLC

  dba MRH Medical Group, Chestnut

  • Rural Health Clinic/Center
  • Aberdeen, MS
  • NPI 1891212957

  Sold to, 2017-10-01

  CMS change of ownership

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212364800000",
    "number": "1083658595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1100",
            "city": "MAGEE",
            "state": "MS",
            "postal_code": "391111100",
            "telephone_number": "601-849-6440",
            "fax_number": "601-849-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S CHESTNUT ST",
            "city": "ABERDEEN",
            "state": "MS",
            "postal_code": "397303337",
            "telephone_number": "601-369-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER HEALTH SERVICES OF MONROE COUNTY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2008-06-02",
        "status": "A",
        "authorized_official_last_name": "MCNULTY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "691-849-4112",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "CRT"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015888",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chestnut Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mississippi State Department of Health
• Kristen Shay O'Brian, PHARM D
• Joel Nathaneal Patterson, PHARMD
• Natalie L Pierce, OTR/L
• Pioneer Family Pharmacy
• Pioneer Health Services of Monroe County, Inc (Pioneer Community Hospital of Aberdeen Swing Bed)
• Pioneer Health Services of Monroe County, Inc (Pioneer Pediatric Clinic)
• Pioneer Health Services of Monroe County, Inc (Nina Jurney Family Medical Practice)
• Pioneer Health Services of Monroe County, Inc. (Pioneer Community Hospital of Aberdeen)
• Pioneer Health Services of Monroe County, Inc. (Pioneer Family Medical)

• Rural Health Clinic/Center in Aberdeen, MS
• Providers in Aberdeen, MS by specialty
• Rural Health Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.

Verify at the official NPI Registry.