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Organization Active NPI

North Sunflower Medical Center

Doing business as North Sunflower Medical Center - CRNA

  • Certified Registered Nurse Anesthetist
  • Ruleville, MS
National Provider Identifier
1104132174
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R679038 Issued in MS
Legal business name
NORTH SUNFLOWER MEDICAL CENTER
Doing business as
North Sunflower Medical Center - CRNA
Practice address
840 N Oak Ave
Ruleville, MS 38771-3227
Phone
(662) 756-2711
Fax
(662) 756-4114
NPI assigned
Aug 27, 2010
Last updated
Jun 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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

Authorized official

Name
Jose Daniel Ceja
Title
Ceo
Phone
(662) 756-2711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R679038 MS Primary

Addresses

Primary practice location

840 N Oak Ave
Ruleville, MS 38771-3227

Mailing address

PO Box 369
Ruleville, MS 38771-0369
Phone (662) 756-2711

Other names 1

  • North Sunflower Medical Center - CRNA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101229001072 MS Part B Supplier - Hospital Department(S) 7618932294 Receives reassigned benefits from 5 practitioners
Practice locations: Ruleville, MS

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
North Sunflower Co Hosp19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
North Sunflower Medical CenterRuleville, MS, CCN 251318 Hospital Operational/Managerial Control (100%) Oct 1, 2004
Sunflower Rural Health CenterRuleville, MS, CCN 253400 Rural health clinic Operational/Managerial Control Oct 1, 2014
Sunflower Greenwood ClinicGreenwood, MS, CCN 258686 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 31, 2023

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1282867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591574400000",
    "number": "1104132174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 369",
            "city": "RULEVILLE",
            "state": "MS",
            "postal_code": "387710369",
            "telephone_number": "662-756-2711",
            "fax_number": "662-756-4114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 N OAK AVE",
            "city": "RULEVILLE",
            "state": "MS",
            "postal_code": "387713227",
            "telephone_number": "662-756-2711",
            "fax_number": "662-756-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SUNFLOWER MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-27",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A",
        "authorized_official_last_name": "CEJA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-756-2711"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R679038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Sunflower Medical Center - CRNA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Sunflower Medical Center - CRNA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ruleville, MS

Sources for this page

Verify at the official NPI Registry.