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Organization Active NPI

Tallahatchie General Hospital

  • Diagnostic Radiology Physician
  • Charleston, MS
National Provider Identifier
1215267232
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
TALLAHATCHIE GENERAL HOSPITAL
Practice address
141 Dr. T T Lewis Circle
Charleston, MS 38921-2236
Phone
(662) 647-5535
Fax
(662) 647-8432
NPI assigned
Jan 14, 2010
Last updated
May 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Authorized official

Name
Heather Holeman Godsey
Title
Revenue Cycle Director
Phone
(662) 625-7191

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary
Critical Access Hospital 282NC0060X 11211 MS

Addresses

Primary practice location

141 Dr. T T Lewis Circle
Charleston, MS 38921-2236

Mailing address

PO Box 230
Charleston, MS 38921-0240
Phone (662) 647-5535

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240110000919 MS Part B Supplier - Hospital Department(S) 1052208097 Receives reassigned benefits from 7 practitioners
Practice locations: Charleston, MS

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Tallahatchie Gen Hosp8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

226 W Walnut St
Charleston, MS 38921
Phone (662) 647-5172

1301 Sunset Dr
Ste E
Grenada, MS 38901
Phone (662) 229-0069

Ownership & related parties

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Tallahatchie General HospitalCharleston, MS, CCN 251304 Hospital 5% Or Greater Direct Ownership Interest Feb 1, 2002
Holcomb ClinicGrenada, MS, CCN 258601 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2015
Tutwiler ClinicTutwiler, MS, CCN 258620 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2016

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 31

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 31

NPI Registry JSON

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

{
    "created_epoch": "1263427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747008000000",
    "number": "1215267232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 230",
            "city": "CHARLESTON",
            "state": "MS",
            "postal_code": "389210240",
            "telephone_number": "662-647-5535",
            "fax_number": "662-647-8432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 DR. T T LEWIS CIRCLE",
            "city": "CHARLESTON",
            "state": "MS",
            "postal_code": "389212236",
            "telephone_number": "662-647-5535",
            "fax_number": "662-647-8432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TALLAHATCHIE GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-14",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A",
        "authorized_official_last_name": "GODSEY",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "HOLEMAN",
        "authorized_official_title_or_position": "REVENUE CYCLE DIRECTOR",
        "authorized_official_telephone_number": "662-625-7191"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "MS",
            "license": "11211",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, MS

Sources for this page

Verify at the official NPI Registry.