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Sumrall High School

Organization Active NPI Federally Qualified Health Center (FQHC) · Sumrall, MS

NPI 1194399360 · NPPES record last updated Feb 5, 2026

Key facts

NPI
1194399360
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
SUMRALL HIGH SCHOOL
Practice address
184 Center Ave
Sumrall, MS 39482-9629
Phone
(601) 758-4730
Fax
(601) 796-9437
NPI assigned
May 13, 2021
Reactivated
Jul 8, 2022
Organization subpart
No

Authorized official

Name
Janice Robinson
Title
Ceo
Phone
(601) 545-8700

Corporate family (same tax ID) 23

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

Facilities with the same owner 36

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 36

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MS

Federally qualified health center certification: CCN 251147

Legal name
SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.
Doing business as
SUMRALL HIGH SCHOOL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 8, 2022
Last certification
Nov 8, 2022
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
May 29, 1979 in MS
Enrollment address
184 Center Ave
Sumrall, MS 39482-9629

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Larry Davis
Individual 		Corporate Director
Board Member		 Mar 23, 2021
Karen Speed
Individual 		Corporate Director
Board Member - President		 Jun 29, 2004
Nanni Freeman
Individual 		Corporate Director
Board Member		 Apr 26, 2005
Southeast Mississippi Rural Health Initiative, Inc.
Organization · Hattiesburg, MS
Corporation, Medical provider/supplier, Non-profit 		5% Or Greater Direct Ownership Interest Sep 1, 2022 100%
Kermit Rayborn
Individual 		Corporate Director
Board Member		 Oct 22, 1996
Maxine Bolton
Individual 		Corporate Director
Board Member - Secretary		 Oct 28, 2014
Janice Robinson
Individual 		Corporate Officer
Ceo		 Jan 23, 2023 100%
Corporate Director
Ceo		 Jan 23, 2023 100%
W-2 Managing Employee
Ceo		 Jan 23, 2023 100%
Billy Folkes
Individual 		Corporate Director
Board Member		 Feb 20, 2007
Virginia Burks
Individual 		Corporate Director
Board Member		 Jan 1, 1995
Joyce Woullard
Individual 		Corporate Director
Board Member - Treasurer		 Sep 26, 1995
Derrick Autmon
Individual 		Corporate Director
Board Member - Vice President		 Jun 23, 2015

All facility ownership & control disclosures 36

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hattiesburg Public School and Community Clinic
Hattiesburg, MS · CCN 251934		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1979
Woodley Elementary School
Hattiesburg, MS · CCN 251942		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1979
Hattiesburg High School and Community Clinic
Hattiesburg, MS · CCN 251943		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1979
N. R. Burger School and Community Clinic
Hattiesburg, MS · CCN 251941		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1979
Minor Care Clinic
Hattiesburg, MS · CCN 251961		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1979
Picayune Family Health Center
Picayune, MS · CCN 251966		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1979
Lumberton Family Health Center
Lumberton, MS · CCN 251865		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1979
Brooklyn Family Health Center
Brooklyn, MS · CCN 251864		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1979
New Augusta Family Health Center
New Augusta, MS · CCN 251816		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1979
Women'S Health Center
Hattiesburg, MS · CCN 251874		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1979
Hattiesburg Family Health Center
Hattiesburg, MS · CCN 251849		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1979
Seminary Family Health Center
Seminary, MS · CCN 251814		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1979
Petal Elementary School
Petal, MS · CCN 251013		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1979
Petal Primary School
Petal, MS · CCN 251017		 Federally qualified health center Operational/Managerial Control (100%) May 29, 1979
Petal Upper Elementary School
Petal, MS · CCN 251016		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1979
Petal Middle School
Petal, MS · CCN 251012		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1976
Petal High School
Petal, MS · CCN 251015		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1976
Hattiesburg High School Campus
Hattiesburg, MS · CCN 251009		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1976
Petal School Clinic
Petal, MS · CCN 251023		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1976
Semrhi Support Service Center
Hattiesburg, MS · CCN 251070		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1976
Forrest County Agricultural High School
Brooklyn, MS · CCN 251068		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1976
Baxterville School (K -8)
Lumberton, MS · CCN 251129		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1979
Purvis Lower Elementary School
Purvis, MS · CCN 251132		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1979
Oak Grove Longleaf
Hattiesburg, MS · CCN 251133		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2022
Purvis High School
Purvis, MS · CCN 251145		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 14, 2022
Sumrall Elementary School
Sumrall, MS · CCN 251136		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2022
Lamar County School Clinic
Purvis, MS · CCN 251138		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2022
Oak Grove Elementary
Hattiesburg, MS · CCN 251146		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2022
Sumrall Middle School
Sumrall, MS · CCN 251139		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2022
Purvis Middle School
Purvis, MS · CCN 251142		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2022
Oak Grove High School
Hattiesburg, MS · CCN 251141		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2022
Oak Grove Middle School
Hattiesburg, MS · CCN 251131		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2022
Lumberton Elementary
Lumberton, MS · CCN 251130		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2022
Purvis Upper Elementary School
Purvis, MS · CCN 251135		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1979
Lumberton High School
Lumberton, MS · CCN 251144		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2022
Bellevue Elementary
Hattiesburg, MS · CCN 251152		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1979

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20220929001959 MS Part a Provider - Federally Qualified Health Center (FQHC) 2466342605 Practice locations: Sumrall, MS

National Provider Directory

Tax ID family
Seminary Clinic (59 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

184 Center Ave
Sumrall, MS 39482-9629

Mailing address

PO Box 1729
Hattiesburg, MS 39403-1729
Phone (601) 545-8700

Other identifiers

IdentifierTypeStateIssuer
200003432MedicaidMS

Other names

  • Sumrall High School Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 5, 2026.

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770249600000",
    "number": "1194399360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1729",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394031729",
            "telephone_number": "601-545-8700",
            "fax_number": "601-450-0231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 CENTER AVE",
            "city": "SUMRALL",
            "state": "MS",
            "postal_code": "394829629",
            "telephone_number": "601-758-4730",
            "fax_number": "601-796-9437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMRALL HIGH SCHOOL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-13",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "deactivation_date": "2021-07-27",
        "reactivation_date": "2022-07-08",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-545-8700"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200003432",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sumrall High School",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sumrall High School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sumrall, MS

All providers in Sumrall, MS · Federally Qualified Health Center (FQHC) in Mississippi

Sources for this page

Verify at the official NPI Registry.