Pioneer Health Services of Monroe County, Inc.

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

PIONEER HEALTH SERVICES OF MONROE COUNTY, INC.

Practice address

502 Jackson Street
Suite 5
Aberdeen, MS 39730-0000

Phone

(662) 369-9500

Fax

(662) 304-4002

NPI assigned

Jun 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Joseph S McNulty III

Title

Ceo/Owner

Phone

(601) 849-6440

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pioneer Family Medical Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Boa Vida Hospital of Aberdeen, Ms, LLC

  • Rural Health Clinic/Center
  • Aberdeen, MS
  • NPI 1245757301

  Sold to, 2017-10-01

  CMS change of ownership

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244592000000",
    "number": "1386689438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1100",
            "city": "MAGEE",
            "state": "MS",
            "postal_code": "391111100",
            "telephone_number": "601-849-1682",
            "fax_number": "601-849-1969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 JACKSON STREET",
            "address_2": "SUITE 5",
            "city": "ABERDEEN",
            "state": "MS",
            "postal_code": "397300000",
            "telephone_number": "662-369-9500",
            "fax_number": "662-304-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER HEALTH SERVICES OF MONROE COUNTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2009-06-10",
        "status": "A",
        "authorized_official_last_name": "MCNULTY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "601-849-6440",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08558036",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pioneer Family Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pioneer Health Services of Monroe County, Inc
• Pioneer Health Services of Monroe County, Inc
• Pioneer Health Services of Monroe County, Inc
• Pioneer Health Services of Monroe County, Inc
• Pioneer Health Services of Monroe County, Inc.
• Pioneer Health Services of Monroe County, Inc.
• Pioneer Health Services of Monroe County, Inc.
• Pioneer Health Services of Monroe County, Inc.
• Pioneer Health Services of Monroe County, Inc.
• Barry Prather, D.P.T.

• Rural Health Clinic/Center in Aberdeen, MS
• Providers in Aberdeen, MS by specialty
• Rural Health Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.