Forrest County General Hospital
Organization Active NPI Surgery Physician · Columbia, MS
NPI 1194099713 · NPPES record last updated Feb 29, 2012
Key facts
- NPI
- 1194099713
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- Legal business name
- FORREST COUNTY GENERAL HOSPITAL
- Practice address
- 910 Sumrall Rd
Columbia, MS 39429-2652 - Phone
- (601) 736-0177
- Fax
- (601) 736-0179
- NPI assigned
- Feb 29, 2012
- Organization subpart
- No
Authorized official
- Name
- Richard Andrew Woodard
- Title
- Cfo
- Phone
- (601) 288-2892
Other NPIs on the same Medicare enrollment 19
Corporate family (same tax ID) 40
Practitioners 3
-
Jason Todd Lane, CRNA
-
Erin Broome Riley, MSN, APRN FNP-C
-
Ronda M. Vanderheiden, F.N.P.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040624001351 | MS | Part B Supplier - Clinic/Group Practice | 1052397767 |
Receives reassigned benefits from 246 practitioners 21 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Prentiss, MS; Poplarville, MS; Hattiesburg, MS; Picayune, MS; Laurel, MS; Columbia, MS |
National Provider Directory
- Tax ID family
- Forrest County Gen Hospital
Locations
910 Sumrall Rd
Columbia, MS 39429
Phone (601) 736-0177
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Internal Medicine Physician |
207R00000X | |||
| Surgery Physician |
208600000X | Yes | ||
| General Practice Physician |
208D00000X |
Addresses
Primary practice location
910 Sumrall Rd
Columbia, MS 39429-2652
Mailing address
910 Sumrall Rd
Columbia, MS 39429-2652
Other names
- Marion County Surgical Clinic
Other providers in Columbia, MS
- Fast Pace Mississippi, PLLC
- Fink Chiropractic Clinic
- Holly Renae Fink
- First Place Physical Therapy LLC
- Forrest County General Hospital
- Forrest County General Hospital
- Forrest County General Hospital
- Forrest County General Hospital
- Forrest County General Hospital
- Forrest County General Hospital
All providers in Columbia, MS · Surgery Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 29, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.