Southeast Mississippi Rural Health Initiative, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.

Practice address

200 Main St
Seminary, MS 39479-0000

Phone

(601) 545-8700

Fax

(601) 450-2493

NPI assigned

Oct 20, 2016

Last updated

Sep 6, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Kaye Ray

Title

Ceo

Phone

(601) 545-8700

Specialties & licenses 1

Addresses

Other names 1

• Seminary Elementary School Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417408980. Details of each certification follow.

• CCN 251062 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 251062

Legal name

SEMINARY ELEMENTARY SCHOOL

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jun 28, 2017

Last certification

Jun 28, 2017

Ownership / control type

For profit – corporation

Facility address

200 W Main St
Seminary, MS 39479

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662422400000",
    "number": "1417408980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1729",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394031729",
            "telephone_number": "601-545-8700",
            "fax_number": "601-450-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MAIN ST",
            "city": "SEMINARY",
            "state": "MS",
            "postal_code": "394790000",
            "telephone_number": "601-545-8700",
            "fax_number": "601-450-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-20",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "KAYE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-545-8700",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seminary Elementary School",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Seminary Elementary School",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• SCPG Mississippi LLC (Cranfords Drug Store)
• Seminary Family Health Center
• Shelley Marie Shoemake, DC
• Linda Walton Smith, LPC
• Southeast Mississippi Rural Health Initiative, Inc.
• Southeast Mississippi Rural Health Initiative, Inc.
• The Cardiovascular & Pulmonary Optimization Institute
• Christian Morgan Whitehead, CCC-SLP
• Donna C Wilcosky, PHARMACIST

• Federally Qualified Health Center (FQHC) in Seminary, MS
• Providers in Seminary, MS by specialty
• Federally Qualified Health Center (FQHC) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.