NPIMap

Organization Active NPI

SMC-Mississippi County Hospital System

  • Rural Acute Care Hospital
  • Osceola, AR
National Provider Identifier
1366685992
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
Legal business name
SMC-MISSISSIPPI COUNTY HOSPITAL SYSTEM
Practice address
611 W Lee Ave
Osceola, AR 72370-3001
Phone
(870) 838-7000
Fax
(870) 838-7493
NPI assigned
Apr 13, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Authorized official

Name
Mrs. Felicia Pierce
Title
Interim Ceo
Phone
(870) 838-7460

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X Primary

Addresses

Primary practice location

611 W Lee Ave
Osceola, AR 72370-3001

Mailing address

PO Box 108
Blytheville, AR 72316-0108
Phone (870) 838-7300

Other identifiers 1

IdentifierTypeStateIssuer
178790105MedicaidAR

Other names 1

  • SMC Regional Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240403003112 AR Part A Provider - Rural Emergency Hospital (Reh) 0941351910 Practice locations: Osceola, AR

Hospital certification: CCN 040782

Legal name
SMC-MISSISSIPPI COUNTY HOSPITAL SYSTEM
Doing business as
SOUTH MISSISSIPPI COUNTY REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Rural emergency hospital
Participating since
May 1, 2024
Last certification
Jan 15, 2025
Beds
1
Ownership / control type
Local
Organization structure
GovernmentNon-profit
Enrollment address
611 W Lee Ave
Osceola, AR 72370-3001
Main/Primary Hospital Location

Care Compare: Hospital

Medicare Care Compare
Listed as
South Mississippi County Regional Medical CenterCCN 040782
Type
Rural Emergency Hospital
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
John Logan Individual Corporate Director Feb 29, 2024
Harry Warren Whitis Individual Corporate OfficerBoard Member Mar 13, 2009
Felicia Pierce Individual Corporate Officer Sep 25, 2024
W-2 Managing EmployeeInterim Ceo Sep 25, 2024
Matthew Perrin Individual Corporate Director Feb 29, 2024
Terry Cole Individual Corporate DirectorBoard Member Feb 29, 2024
Van Parker Individual Corporate DirectorBoard Member Feb 29, 2024
Mississippi County Arkansas Organization, Blytheville, AR Non-profit 5% Or Greater Direct Ownership Interest Feb 29, 2024 100%
Matthew E Jones Individual Corporate DirectorBoard Member Feb 29, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 20

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1366685992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 108",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723160108",
            "telephone_number": "870-838-7300",
            "fax_number": "870-838-7493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W LEE AVE",
            "city": "OSCEOLA",
            "state": "AR",
            "postal_code": "723703001",
            "telephone_number": "870-838-7000",
            "fax_number": "870-838-7493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMC-MISSISSIPPI COUNTY HOSPITAL SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-13",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "PIERCE",
        "authorized_official_first_name": "FELICIA",
        "authorized_official_title_or_position": "INTERIM CEO",
        "authorized_official_telephone_number": "870-838-7460",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178790105",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMC Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Osceola, AR

Sources for this page

Verify at the official NPI Registry.