NPIMap

Organization Active NPI

Southwest Mississippi Regional Medical Center

Doing business as Mississippi Cancer Institute

  • General Acute Care Hospital
  • McComb, MS
National Provider Identifier
1467700666
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
11-251 Issued in MS
Legal business name
SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER
Doing business as
Mississippi Cancer Institute
Practice address
1501 Aston Ave
McComb, MS 39648-2734
Phone
(601) 249-5510
Fax
(601) 250-4242
NPI assigned
Aug 17, 2012
Last updated
Nov 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Authorized official

Name
Mrs. Charla Rowley
Title
Ceo
Phone
(601) 249-1806

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X
General Acute Care Hospital 282N00000X 11-251 MS Primary

Addresses

Primary practice location

1501 Aston Ave
McComb, MS 39648-2734

Mailing address

215 Marion Ave
McComb, MS 39648-2705
Phone (601) 249-1183

Other names 1

  • Mississippi Cancer Institute Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120910000766 MS Part B Supplier - Clinic/Group Practice 5193633907 Receives reassigned benefits from 2 practitioners
Practice locations: McComb, MS

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2061400Smrmc - the Mississippi Cancer Institute1501 Aston Ave 2ND Floor, McComb, MS 39648ComplianceJan 30, 2028

National Provider Directory

National Provider Directory
Tax ID family
Smrmc Dba SW Internal M34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

Organizations that report the same tax identification number in the National Provider Directory.

View all 33

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St. Luke Home Health and HospiceMcComb, MS, CCN 257124 Home health agency 5% Or Greater Indirect Ownership Interest (100%) Oct 1, 2001
St. Luke Home Health and HospiceMonticello, MS, CCN 251687 Hospice 5% Or Greater Indirect Ownership Interest (100%) Feb 22, 2002
Southwest Primary CareMcComb, MS, CCN 258567 Rural health clinic 5% Or Greater Direct Ownership Interest Feb 1, 2012
Womens Health CenterMcComb, MS, CCN 258642 Rural health clinic 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Nov 1, 2019
Nov 1, 2019
Lawrence County Board of SupervisorsMonticello, MS, CCN 258692 Rural health clinic Operational/Managerial Control Sep 27, 2001

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1345161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668384000000",
    "number": "1467700666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 MARION AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482705",
            "telephone_number": "601-249-1183",
            "fax_number": "601-249-1709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 ASTON AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482734",
            "telephone_number": "601-249-5510",
            "fax_number": "601-250-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-17",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A",
        "authorized_official_last_name": "ROWLEY",
        "authorized_official_first_name": "CHARLA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-249-1806",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MS",
            "license": "11-251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mississippi Cancer Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mississippi Cancer Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McComb, MS

Sources for this page

Verify at the official NPI Registry.