NPIMap

Organization Active NPI

Tishomingo Health Services, Inc.

Doing business as Tishomingo Health Services

  • Land Ambulance
  • Iuka, MS
National Provider Identifier
1265543516
Registry record updated Nov 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
13-221 Issued in MS
Legal business name
TISHOMINGO HEALTH SERVICES, INC.
Doing business as
Tishomingo Health Services
Practice address
1777 Curtis Dr
Iuka, MS 38852
Phone
(662) 423-4074
Fax
(662) 423-4550
NPI assigned
Aug 31, 2006
Last updated
Nov 11, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
TISHOMINGO HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 11, 2011

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

Authorized official

Name
Mr. Joseph A Reppert
Title
Cfo
Phone
(662) 377-3978

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 13-221 MS Primary

Addresses

Primary practice location

1777 Curtis Dr
Iuka, MS 38852

Mailing address

1777 Curtis Dr
Iuka, MS 38852
Phone (662) 423-4074

Other identifiers 1

IdentifierTypeStateIssuer
0050405MedicaidMS

Other names 1

  • Tishomingo Health Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Tishomingo Hospital8 organizations share this tax ID, including this one
Part of
Tishomingo Hospital

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320969600000",
    "number": "1265543516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 CURTIS DR",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "38852",
            "telephone_number": "662-423-4074",
            "fax_number": "662-423-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 CURTIS DR",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "38852",
            "telephone_number": "662-423-4074",
            "fax_number": "662-423-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TISHOMINGO HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TISHOMINGO HEALTH SERVICES, INC.",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-11-11",
        "status": "A",
        "authorized_official_last_name": "REPPERT",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "662-377-3978",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MS",
            "license": "13-221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0050405",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tishomingo Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Iuka, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.