Mississippi State Department of Health

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

9281 Issued in MS

Legal business name

MISSISSIPPI STATE DEPARTMENT OF HEALTH

Practice address

1130 North Park Ave
Magnolia, MS 39682

Phone

(601) 684-4294

Fax

(601) 249-0421

NPI assigned

Dec 14, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Melanie Bowman, RN

Title

Director of Home Health

Phone

(601) 576-7853

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Southwest Home Health Agency 7C Doing business as

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216944000000",
    "number": "1295710135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 NORTH PARK AVE",
            "city": "MAGNOLIA",
            "state": "MS",
            "postal_code": "39682",
            "telephone_number": "601-684-4294",
            "fax_number": "601-249-0421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 NORTH PARK AVE",
            "city": "MAGNOLIA",
            "state": "MS",
            "postal_code": "39682",
            "telephone_number": "601-684-4294",
            "fax_number": "601-249-0421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI STATE DEPARTMENT OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-14",
        "last_updated": "2008-07-25",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "DIRECTOR OF HOME HEALTH",
        "authorized_official_telephone_number": "601-576-7853",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MS",
            "license": "9281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00070500",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwest Home Health Agency 7C",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Magnolia Clinic, Inc.
• Magnolia Family Dental, PLLC
• Magnolia Rehab Company
• Bryan Barret Martin, D.M.D.
• Jessica Rene' Mason, FNP-BC
• Lindsey Joan Nobles, FNP-C
• Sharee Nobles, NP
• Rebecca Ann Rayborn, PMHNP
• Renew Hope Transition Living, Inc.
• Tamelia Robinson, LPTA

• All providers in Magnolia, MS
• Home Health Agency in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2008; 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.