NPIMap

Organization Active NPI

Patients' Choice Medical Center of Humphreys County, LLC

  • Rural Health Clinic/Center
  • Belzoni, MS
National Provider Identifier
1366628927
Registry record updated May 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
PATIENTS' CHOICE MEDICAL CENTER OF HUMPHREYS COUNTY, LLC
Practice address
500 CCC Rd
Belzoni, MS 39038
Phone
(662) 247-3874
NPI assigned
Jan 14, 2008
Last updated
May 29, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
RURAL HEALTHCARE DEVELOPERS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 29, 2009

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

Authorized official

Name
Mr. Ray Shoemaker
Title
Ceo
Phone
(662) 247-3874

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary
Family Medicine Physician 207Q00000X

Addresses

Primary practice location

500 CCC Rd
Belzoni, MS 39038

Mailing address

500 CCC Road
Belzoni, MS 39038-0510
Phone (662) 247-3874

Other identifiers 1

IdentifierTypeStateIssuer
09014821MedicaidMS

Other names 1

  • Church Street Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
Patients' Choice Medical Center of Humphreys County LLC6 organizations share this tax ID, including this one
Part of
Rural Healthcare Developers

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243555200000",
    "number": "1366628927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CCC ROAD",
            "city": "BELZONI",
            "state": "MS",
            "postal_code": "390380510",
            "telephone_number": "662-247-3874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CCC RD",
            "city": "BELZONI",
            "state": "MS",
            "postal_code": "39038",
            "telephone_number": "662-247-3874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATIENTS' CHOICE MEDICAL CENTER OF HUMPHREYS COUNTY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RURAL HEALTHCARE DEVELOPERS, INC",
        "enumeration_date": "2008-01-14",
        "last_updated": "2009-05-29",
        "status": "A",
        "authorized_official_last_name": "SHOEMAKER",
        "authorized_official_first_name": "RAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-247-3874",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09014821",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Church Street Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Belzoni, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2009; 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.