Magnolia Health Plan, Inc.

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

MAGNOLIA HEALTH PLAN, INC.

Practice address

1020 Highland Colony Pkwy
Ridgeland, MS 39157-2137

Phone

(877) 687-1187

NPI assigned

Sep 28, 2020

Organization subpart

No

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

Authorized official

Name

Kenneth Koshorek

Title

VP, Associate General Counsel

Phone

(313) 720-5567

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763078400000",
    "number": "1386251908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 FORSYTH BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631051813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 HIGHLAND COLONY PKWY",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391572137",
            "telephone_number": "877-687-1187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA HEALTH PLAN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-28",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A",
        "authorized_official_last_name": "KOSHOREK",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "VP, ASSOCIATE GENERAL COUNSEL",
        "authorized_official_telephone_number": "313-720-5567"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shenia Lyons, PH.D.
• Madison Community Care Center LLC
• Madison County Schools
• Madison Ridgeland Children'S Clinic
• Holly H. Magee, M.S., C.C.C., SLP
• Magnolia Premier Medical Group PLLC
• Samuel Maison
• Hope Michelle Mallard
• Meagen M Mallett, OT
• Heather J Maloney, PT

• All providers in Ridgeland, MS
• Health Maintenance Organization in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; 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.