NPIMap

Organization Active NPI

Jefferson County Hospital

  • Psychiatric Hospital Unit
  • Fayette, MS
National Provider Identifier
1386018083
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
21-238 Issued in MS
Legal business name
JEFFERSON COUNTY HOSPITAL
Practice address
870 Main St
Fayette, MS 39069-5695
Phone
(601) 786-3401
Fax
(601) 786-3400
NPI assigned
Nov 18, 2015
Last updated
Nov 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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

Authorized official

Name
Mrs. Wanda Fleming
Title
Administrator
Phone
(601) 786-3401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 21-238 MS Primary

Addresses

Primary practice location

870 Main St
Fayette, MS 39069-5695

Mailing address

PO Box 577
Fayette, MS 39069-0577
Phone (601) 786-3401

Other identifiers 1

IdentifierTypeStateIssuer
25S060OtherMSMEDICARE PTAN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1386018083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 577",
            "city": "FAYETTE",
            "state": "MS",
            "postal_code": "390690577",
            "telephone_number": "601-786-3401",
            "fax_number": "601-786-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 MAIN ST",
            "city": "FAYETTE",
            "state": "MS",
            "postal_code": "390695695",
            "telephone_number": "601-786-3401",
            "fax_number": "601-786-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-18",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "FLEMING",
        "authorized_official_first_name": "WANDA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "601-786-3401",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "MS",
            "license": "21-238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "25S060",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayette, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.