Southern Health Corp of Houston, Inc.

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

12296 Issued in MS

Legal business name

SOUTHERN HEALTH CORP OF HOUSTON, INC.

Practice address

1002 E Madison St
Houston, MS 38851-2428

Phone

(662) 456-3700

Fax

(662) 456-1083

NPI assigned

Jul 26, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Sheila Brockman

Title

Ceo

Phone

(662) 456-3700

Specialties & licenses 1

Addresses

Other identifiers 8

Other names 1

• Trace Regional Hospital Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Southern Health Corp. of Houston, Inc.

  • Rural Health Clinic/Center
  • Houston, MS
  • NPI 1194833400

  Member Of

  NPD member

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1366465502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 626",
            "city": "HOUSTON",
            "state": "MS",
            "postal_code": "38851",
            "telephone_number": "662-456-3701",
            "fax_number": "662-456-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 E MADISON ST",
            "city": "HOUSTON",
            "state": "MS",
            "postal_code": "388512428",
            "telephone_number": "662-456-3700",
            "fax_number": "662-456-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN HEALTH CORP OF HOUSTON, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A",
        "authorized_official_last_name": "BROCKMAN",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-456-3700",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MS",
            "license": "12296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE / CAHABA",
            "identifier": "C 02044",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE / CAHABA",
            "identifier": "C02335",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00220415",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09013117",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09013354",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE / CAHABA",
            "identifier": "C00717",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "000020031",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00220424",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trace Regional Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Trace Regional Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseph Lee Rutherford, DC
• Deborah Smith, PHARMD
• Southern Health Corp of Houston Inc
• Southern Health Corp of Houston Inc
• Southern Health Corp of Houston Inc
• Southern Health Corp. of Houston, Inc
• Southern Health Corp. of Houston, Inc
• Southern Health Corp. of Houston, Inc.
• Southern Health Corp. of Houston, Inc.
• Southern Mobility Specialists Inc

• All providers in Houston, MS
• General Acute Care Hospital in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.