NPIMap

Organization Active NPI

Brandywine Health Services of Mississippi, Inc

Doing business as Choctaw County Medical Center

  • Critical Access Hospital
  • Ackerman, MS
National Provider Identifier
1356339576
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
16191 Issued in MS
Legal business name
BRANDYWINE HEALTH SERVICES OF MISSISSIPPI, INC
Doing business as
Choctaw County Medical Center
Practice address
311 West Cherry Street
Ackerman, MS 39735
Phone
(662) 285-6235
Fax
(662) 285-2516
NPI assigned
Oct 11, 2005
Last updated
Jul 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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

Authorized official

Name
Ray Shoemaker
Title
Ceo
Phone
(662) 321-1155

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 16191 MS Primary

Addresses

Primary practice location

311 West Cherry Street
Ackerman, MS 39735

Mailing address

PO Box 1039
Ackerman, MS 39735-1039
Phone (662) 285-6235

Other identifiers 1

IdentifierTypeStateIssuer
02032374MedicaidMS

Other names 1

  • Choctaw County Medical Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1356339576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1039",
            "city": "ACKERMAN",
            "state": "MS",
            "postal_code": "397351039",
            "telephone_number": "662-285-6235",
            "fax_number": "662-285-2516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 WEST CHERRY STREET",
            "city": "ACKERMAN",
            "state": "MS",
            "postal_code": "39735",
            "telephone_number": "662-285-6235",
            "fax_number": "662-285-2516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDYWINE HEALTH SERVICES OF MISSISSIPPI, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "SHOEMAKER",
        "authorized_official_first_name": "RAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-321-1155"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "MS",
            "license": "16191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02032374",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Choctaw County Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ackerman, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.