NPIMap

Organization Active NPI

Independent Healthcare Management, Inc.

Doing business as Forest Orthopedics and Pain Management

  • Clinic/Center
  • Forest, MS
National Provider Identifier
1295465805
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
INDEPENDENT HEALTHCARE MANAGEMENT, INC.
Doing business as
Forest Orthopedics and Pain Management
Practice address
516 Airport Rd
Forest, MS 39074-4032
Phone
(601) 469-4151
NPI assigned
Jun 15, 2022
Last updated
Jun 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Authorized official

Name
John Lee, MDNPI 1992806699
Title
Cob
Phone
(601) 469-4861

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

516 Airport Rd
Forest, MS 39074-4032

Mailing address

360 Simpson Highway 149 Ste 140
Magee, MS 39111-3840
Phone (601) 849-6440

Other identifiers 1

IdentifierTypeStateIssuer
13-033OtherMSSTATE LICENSE

Other names 1

  • Forest Orthopedics and Pain Management Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031215000487 MS Part B Supplier - Clinic/Group Practice 0840197232 Receives reassigned benefits from 95 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Raleigh, MS; Newton, MS; Morton, MS; Magee, MS; Forest, MS

Other NPIs on the same Medicare enrollment 13

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

View all 13

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2286614Forest Orthopedics and Pain Management Clinic516 Airport Rd, Forest, MS 39074Certificate of waiverJul 31, 2027

National Provider Directory

National Provider Directory
Tax ID family
SE Lackey Memorial Hosp15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

1129 Highway 35 S
Forest, MS 39074

330 N Broad St
Forest, MS 39074
Phone (601) 469-4151

504 Airport Rd
Ste C
Forest, MS 39074
Phone (601) 333-2373

Practitioners & affiliated clinicians

Practitioners 11

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": "1655251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655251200000",
    "number": "1295465805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 SIMPSON HIGHWAY 149 STE 140",
            "city": "MAGEE",
            "state": "MS",
            "postal_code": "391113840",
            "telephone_number": "601-849-6440",
            "fax_number": "601-849-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 AIRPORT RD",
            "city": "FOREST",
            "state": "MS",
            "postal_code": "390744032",
            "telephone_number": "601-469-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT HEALTHCARE MANAGEMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-15",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-10",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "COB",
        "authorized_official_telephone_number": "601-469-4861",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "13-033",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forest Orthopedics and Pain Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Forest, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.