Southwest Mississippi Regional Medical Center
Organization Active NPI Hospitalist Physician · Monticello, MS
NPI 1497468151 · NPPES record last updated Dec 27, 2022
Key facts
- NPI
- 1497468151
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hospitalist Physician 208M00000X
- Legal business name
- SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER
- Practice address
- 1065 E Broad St
Monticello, MS 39654-7703 - Phone
- (601) 587-4051
- Fax
- (601) 587-0306
- NPI assigned
- Dec 27, 2022
- Organization subpart
- No
Authorized official
- Name
- Charla Rowley
- Title
- Ceo
- Phone
- (601) 249-1806
Other NPIs on the same Medicare enrollment 3
Corporate family (same tax ID) 32
Practitioners 6
-
Brandy Carr Wilson, FNP
-
Walid Semaan, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080512000089 | MS | Part B Supplier - Clinic/Group Practice | 5193633907 |
Receives reassigned benefits from 13 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Monticello, MS |
National Provider Directory
- Tax ID family
- Smrmcgastroenterology
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician |
208M00000X | Yes |
Addresses
Primary practice location
1065 E Broad St
Monticello, MS 39654-7703
Mailing address
PO Box 490
McComb, MS 39649-0490
Phone (601) 250-4366
Other names
- Lawrence County Hospitalists
Other providers in Monticello, MS
- Shannon Smith
- South Mississippi Medical Supply and Veterans Serivces, LLC
- Southwest Mississippi Planning and Development District
- Southwest Mississippi Regional Medical Center
- Southwest Mississippi Regional Medical Center
- Southwest Mississippi Regional Medical Center
- Southwest Mississippi Regional Medical Center
- Southwest Mississippi Regional Medical Center
- Southwest Mississippi Regional Medical Center
- Southwest Mississippi Regional Medical Center
All providers in Monticello, MS · Hospitalist Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 27, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.