NPIMap

Organization Active NPI

Delta Health Center

  • Federally Qualified Health Center (FQHC)
  • Mound Bayou, MS
National Provider Identifier
1487723227
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
R745833 Issued in MS
Legal business name
DELTA HEALTH CENTER
Practice address
702 Martin Luther King St
Mound Bayou, MS 38762-9314
Phone
(662) 741-2151
Fax
(662) 741-2268
NPI assigned
Nov 7, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Seymour Mitchell
Title
Ceo
Phone
(662) 741-2151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X R745833 MS Primary

Addresses

Primary practice location

702 Martin Luther King St
Mound Bayou, MS 38762-9314

Mailing address

702 Martin Luther King St
Mound Bayou, MS 38762-9314
Phone (662) 741-2151

Other identifiers 1

IdentifierTypeStateIssuer
01582712MedicaidMS

National Provider Directory

National Provider Directory
Tax ID family
Delta Health Clinic Inc34 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

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487723227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 MARTIN LUTHER KING ST",
            "city": "MOUND BAYOU",
            "state": "MS",
            "postal_code": "387629314",
            "telephone_number": "662-741-2151",
            "fax_number": "662-741-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 MARTIN LUTHER KING ST",
            "city": "MOUND BAYOU",
            "state": "MS",
            "postal_code": "387629314",
            "telephone_number": "662-741-2151",
            "fax_number": "662-741-2268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "SEYMOUR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-741-2151",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "MS",
            "license": "R745833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01582712",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mound Bayou, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.