NPIMap

Organization Active NPI

RH Hospitalist Medicine of Jefferson Davis LLC

  • Hospitalist Physician
  • Prentiss, MS
National Provider Identifier
1174385355
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
RH HOSPITALIST MEDICINE OF JEFFERSON DAVIS LLC
Practice address
1102 Rose St
Prentiss, MS 39474-5200
Phone
(601) 792-4276
NPI assigned
Jan 24, 2024
Last updated
Sep 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Authorized official

Name
Jennifer Kathryn Wakeford
Title
Entrprise Cfo
Phone
(205) 901-5103

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X Primary

Addresses

Primary practice location

1102 Rose St
Prentiss, MS 39474-5200

Mailing address

PO Box 7058
Tupelo, MS 38802-7058

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240423003254 MS Part B Supplier - Clinic/Group Practice 6103265145 Receives reassigned benefits from 58 practitioners
Practice locations: Prentiss, MS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 58

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.

View all 58

NPI Registry JSON

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

{
    "created_epoch": "1706054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1174385355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7058",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388027058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 ROSE ST",
            "city": "PRENTISS",
            "state": "MS",
            "postal_code": "394745200",
            "telephone_number": "601-792-4276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RH HOSPITALIST MEDICINE OF JEFFERSON DAVIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-24",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "WAKEFORD",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "KATHRYN",
        "authorized_official_title_or_position": "ENTRPRISE CFO",
        "authorized_official_telephone_number": "205-901-5103"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prentiss, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.