NPIMap

Organization Active NPI

Neshoba County General Hospital

Doing business as Neshoba Urgent Care Clinic

  • Family Nurse Practitioner
  • Philadelphia, MS
National Provider Identifier
1144775107
Registry record updated Aug 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
901576 Issued in MS
Legal business name
NESHOBA COUNTY GENERAL HOSPITAL
Doing business as
Neshoba Urgent Care Clinic
Practice address
1120 E Main St
Suite 1
Philadelphia, MS 39350-2300
Phone
(601) 656-1465
Fax
(601) 656-2752
NPI assigned
Aug 19, 2016
Last updated
Aug 19, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
NESHOBA COUNTY GENERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 19, 2016

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

Authorized official

Name
Shannon Dawn Kirkland, FNPNPI 1326593153
Title
Family Nurse Practitioner
Phone
(601) 656-1465

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 901576 MS Primary

Addresses

Primary practice location

1120 E Main St
Suite 1
Philadelphia, MS 39350-2300

Mailing address

1120 E Main St
Suite 1
Philadelphia, MS 39350-2300
Phone (601) 656-1465

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidMS

Other names 1

  • Neshoba Urgent Care Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ms Neurodiagnostic Lab16 organizations share this tax ID, including this one
Part of
Ms Neurodiagnostic Lab

Other organizations with this tax ID 15

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

View all 15

Practitioners & affiliated clinicians

Practitioners 2

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": "1471564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471564800000",
    "number": "1144775107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 E MAIN ST",
            "address_2": "SUITE 1",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502300",
            "telephone_number": "601-656-1465",
            "fax_number": "601-656-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 E MAIN ST",
            "address_2": "SUITE 1",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502300",
            "telephone_number": "601-656-1465",
            "fax_number": "601-656-2752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NESHOBA COUNTY GENERAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NESHOBA COUNTY GENERAL HOSPITAL",
        "enumeration_date": "2016-08-19",
        "last_updated": "2016-08-19",
        "status": "A",
        "authorized_official_last_name": "KIRKLAND",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "601-656-1465",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "901576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neshoba Urgent Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.