NPIMap

Organization Active NPI

Region IV Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Booneville, MS
National Provider Identifier
1487984407
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
REGION IV MENTAL HEALTH
Practice address
2301C East Chambers Dr
Booneville, MS 38829-8903
Phone
(662) 720-4816
Fax
(662) 720-4832
NPI assigned
Jan 14, 2010
Organization subpart
Yes
Parent organization
REGION IV MENTAL HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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

Authorized official

Name
Mr. Charlie Spearman Sr.
Title
Execuitive Director
Phone
(662) 720-4816

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X MS Primary

Addresses

Primary practice location

2301C East Chambers Dr
Booneville, MS 38829-8903

Mailing address

PO Box 839
Corinth, MS 38835-0839
Phone (662) 720-4816

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081031000223 MS Part B Supplier - Clinic/Group Practice 4688733991 Receives reassigned benefits from 25 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Iuka, MS; Ripley, MS; Hernando, MS; Corinth, MS; Booneville, MS; Batesville, MS

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Southaven Services31 organizations share this tax ID, including this one
Part of
Southaven Services

Other organizations with this tax ID 30

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

View all 30

Locations

2301 E Chambers Dr
#C
Booneville, MS 38829
Phone (662) 720-4816

2100 E Chambers Dr
Booneville, MS 38829
Phone (662) 728-3137

2664 S Harper Rd
Corinth, MS 38834
Phone (662) 287-4055

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1263427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479859200000",
    "number": "1487984407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 839",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388350839",
            "telephone_number": "662-720-4816",
            "fax_number": "662-720-4832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301C EAST CHAMBERS DR",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388298903",
            "telephone_number": "662-720-4816",
            "fax_number": "662-720-4832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGION IV MENTAL HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REGION IV MENTAL HEALTH SERVICES, INC.",
        "enumeration_date": "2010-01-14",
        "last_updated": "2016-11-23",
        "status": "A",
        "authorized_official_last_name": "SPEARMAN",
        "authorized_official_first_name": "CHARLIE",
        "authorized_official_title_or_position": "EXECUITIVE DIRECTOR",
        "authorized_official_telephone_number": "662-720-4816",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Booneville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.