NPIMap

Organization Active NPI

Prentiss Regional Hospital and Ecf, Inc.

Doing business as Jefferson Davis Community Hospital Regional Medical Clinic

  • Critical Access Hospital Clinic/Center
  • Bassfield, MS
National Provider Identifier
1417146259
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access Hospital Clinic/CenterTaxonomy code 261QC0050X
License
16179 Issued in MS
Legal business name
PRENTISS REGIONAL HOSPITAL AND ECF, INC.
Doing business as
Jefferson Davis Community Hospital Regional Medical Clinic
Practice address
4297 Highway 42
Bassfield, MS 39421
Phone
(601) 943-5060
NPI assigned
Oct 17, 2007
Last updated
Oct 17, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Authorized official

Name
Mr. Gary Lee McCall Jr.
Title
Coo
Phone
(601) 792-4276

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital Clinic/Center 261QC0050X 16179 MS Primary

Addresses

Primary practice location

4297 Highway 42
Bassfield, MS 39421

Mailing address

PO Box 1288
1102 Rose St
Prentiss, MS 39474-1288
Phone (601) 792-4276

Other names 1

  • Jefferson Davis Community Hospital Regional Medical Clinic Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1417146259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1288",
            "address_2": "1102 ROSE ST",
            "city": "PRENTISS",
            "state": "MS",
            "postal_code": "394741288",
            "telephone_number": "601-792-4276",
            "fax_number": "601-792-2947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4297 HIGHWAY 42",
            "city": "BASSFIELD",
            "state": "MS",
            "postal_code": "39421",
            "telephone_number": "601-943-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRENTISS REGIONAL HOSPITAL AND ECF, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "MCCALL",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "601-792-4276",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QC0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Critical Access Hospital",
            "state": "MS",
            "license": "16179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jefferson Davis Community Hospital Regional Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bassfield, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; 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.