NPIMap

Organization Active NPI

South Mississippi Health Service, Inc

Doing business as South Mississippi Psychiatric Group

  • Psychiatry Physician
  • Hattiesburg, MS
National Provider Identifier
1447356902
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SOUTH MISSISSIPPI HEALTH SERVICE, INC
Doing business as
South Mississippi Psychiatric Group
Practice address
1 Lincoln Pkwy Ste 202
Hattiesburg, MS 39402-3261
Phone
(601) 288-8050
NPI assigned
Sep 15, 2006
Last updated
Jan 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Authorized official

Name
Mrs. Debbie F Sanford
Title
Adminstrator
Phone
(601) 288-4800

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU
Clinical Psychologist 103TC0700X NU
Counseling Psychologist 103TC1900X NU
Clinical Social Worker 1041C0700X NU
Marriage & Family Therapist 106H00000X NU
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X NU
Psychiatry Physician 2084P0800X NU Primary
Child & Adolescent Psychiatry Physician 2084P0804X NU
Geriatric Psychiatry Physician 2084P0805X NU

Addresses

Primary practice location

1 Lincoln Pkwy Ste 202
Hattiesburg, MS 39402-3261

Mailing address

1 Lincoln Pkwy Ste 202
Hattiesburg, MS 39402-3261
Phone (601) 288-8050

Other identifiers 1

IdentifierTypeStateIssuer
09015143MedicaidMS

Other names 1

  • SOUTH MISSISSIPPI PSYCHIATRIC GROUP Doing business as

National Provider Directory

National Provider Directory

Locations

1 Lincoln Pkwy
Ste 202
Hattiesburg, MS 39402
Phone (601) 288-8050

1101B S 28th Ave
Hattiesburg, MS 39402
Phone (601) 288-8050

1611 S 28th Ave
Hattiesburg, MS 39402
Phone (601) 288-8050

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200355200000",
    "number": "1447356902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LINCOLN PKWY STE 202",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023261",
            "telephone_number": "601-288-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LINCOLN PKWY STE 202",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023261",
            "telephone_number": "601-288-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH MISSISSIPPI HEALTH SERVICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2008-01-15",
        "status": "A",
        "authorized_official_last_name": "SANFORD",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "ADMINSTRATOR",
        "authorized_official_telephone_number": "601-288-4800",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015143",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH MISSISSIPPI PSYCHIATRIC GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; 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.