NPIMap

Organization Active NPI

Claiborne County Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Port Gibson, MS
National Provider Identifier
1104904457
Registry record updated Jun 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
CLAIBORNE COUNTY HOSPITAL
Practice address
123 McComb Avenue
Port Gibson, MS 39150-1004
Phone
(601) 437-5141
Fax
(601) 437-8547
NPI assigned
Nov 2, 2006
Last updated
Jun 14, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2010

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

Authorized official

Name
Ray L Shoemaker
Title
Ceo
Phone
(662) 321-1155

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X NU Primary

Addresses

Primary practice location

123 McComb Avenue
Port Gibson, MS 39150-1004

Mailing address

123 McComb Avenue
Port Gibson, MS 39150-1004
Phone (601) 437-5141

Other identifiers 1

IdentifierTypeStateIssuer
00029140MedicaidMS

National Provider Directory

National Provider Directory
Tax ID family
Claiborne County Hospital5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276473600000",
    "number": "1104904457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 MCCOMB AVENUE",
            "city": "PORT GIBSON",
            "state": "MS",
            "postal_code": "391501004",
            "telephone_number": "601-437-5141",
            "fax_number": "601-437-5166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 MCCOMB AVENUE",
            "city": "PORT GIBSON",
            "state": "MS",
            "postal_code": "391501004",
            "telephone_number": "601-437-5141",
            "fax_number": "601-437-8547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAIBORNE COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2010-06-14",
        "status": "A",
        "authorized_official_last_name": "SHOEMAKER",
        "authorized_official_first_name": "RAY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-321-1155"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00029140",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Gibson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2010; 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.