NPIMap

Organization Active NPI

Southwest Mississippi Regional Medical Center

  • Family Medicine Physician
  • McComb, MS
National Provider Identifier
1366066060
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER
Practice address
200 Marion Ave
McComb, MS 39648-2706
Phone
(601) 250-4381
Fax
(601) 250-4367
NPI assigned
May 29, 2020
Organization subpart
Yes
Parent organization
SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Authorized official

Name
Angela Maria Weems
Title
Enrollments
Phone
(601) 250-4366

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

200 Marion Ave
McComb, MS 39648-2706

Mailing address

PO Box 490
McComb, MS 39649-0490
Phone (601) 250-4366

Other identifiers 1

IdentifierTypeStateIssuer
02004101MedicaidMS

Other names 1

  • Southwest Transitional Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080512000004 MS Part B Supplier - Clinic/Group Practice 5193633907 Receives reassigned benefits from 86 practitioners
28 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: McComb, MS; Summit, MS; Monticello, MS

Other NPIs on the same Medicare enrollment 22

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

View all 22

National Provider Directory

National Provider Directory
Tax ID family
Smrmcgastroenterology33 organizations share this tax ID, including this one
Part of
Smrmcgastroenterology

Other organizations with this tax ID 32

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

View all 32

Locations

200 Marion Ave
Ste 1
McComb, MS 39648

300 Rawls Dr
Ste I
McComb, MS 39648
Phone (601) 249-4710

300 Rawls Dr
Ste 700
McComb, MS 39648
Phone (601) 250-4381

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787875200000",
    "number": "1366066060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396490490",
            "telephone_number": "601-250-4366",
            "fax_number": "601-250-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MARION AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482706",
            "telephone_number": "601-250-4381",
            "fax_number": "601-250-4367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER",
        "enumeration_date": "2020-05-29",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A",
        "authorized_official_last_name": "WEEMS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "ENROLLMENTS",
        "authorized_official_telephone_number": "601-250-4366"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02004101",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwest Transitional Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southwest Transitional Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McComb, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.