NPIMap

Organization Active NPI

Forrest County General Hospital

Doing business as Marion County Surgical Clinic

  • Surgery Physician
  • Columbia, MS
National Provider Identifier
1194099713
Registry record updated Feb 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
FORREST COUNTY GENERAL HOSPITAL
Doing business as
Marion County Surgical Clinic
Practice address
910 Sumrall Rd
Columbia, MS 39429-2652
Phone
(601) 736-0177
Fax
(601) 736-0179
NPI assigned
Feb 29, 2012
Last updated
Feb 29, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2012

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

Authorized official

Name
Richard Andrew Woodard
Title
Cfo
Phone
(601) 288-2892

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X

Addresses

Primary practice location

910 Sumrall Rd
Columbia, MS 39429-2652

Mailing address

910 Sumrall Rd
Columbia, MS 39429-2652

Other names 1

  • Marion County Surgical Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

National Provider Directory

National Provider Directory
Tax ID family
Forrest Cty Gen Hosp41 organizations share this tax ID, including this one

Other organizations with this tax ID 40

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

View all 40

Practitioners & affiliated clinicians

Practitioners 3

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": "1330473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330473600000",
    "number": "1194099713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 SUMRALL RD",
            "city": "COLUMBIA",
            "state": "MS",
            "postal_code": "394292652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 SUMRALL RD",
            "city": "COLUMBIA",
            "state": "MS",
            "postal_code": "394292652",
            "telephone_number": "601-736-0177",
            "fax_number": "601-736-0179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORREST COUNTY GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-29",
        "last_updated": "2012-02-29",
        "status": "A",
        "authorized_official_last_name": "WOODARD",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "601-288-2892"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marion County Surgical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; 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.