NPIMap

Organization Active NPI

Northeast Mississippi Community Services, Inc..

  • Driver
  • Booneville, MS
National Provider Identifier
1508906223
Registry record updated Jul 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
Legal business name
NORTHEAST MISSISSIPPI COMMUNITY SERVICES, INC..
Practice address
801 Hatchie St
Booneville, MS 38829-4803
Phone
(662) 728-2118
Fax
(662) 728-8720
NPI assigned
Feb 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2011

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

Authorized official

Name
Mrs. Sonia Presley
Title
Fiscal Officer
Phone
(662) 728-2118

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DriverGroup: 193200000X MULTI-SPECIALTY GROUP 172A00000X Primary
HomemakerGroup: 193200000X MULTI-SPECIALTY GROUP 376J00000X
Respite Care 385H00000X

Addresses

Primary practice location

801 Hatchie St
Booneville, MS 38829-4803

Mailing address

PO Box 930
Booneville, MS 38829-0930
Phone (662) 728-2118

Other identifiers 3

IdentifierTypeStateIssuer
07178254MedicaidMS
00770067MedicaidMS
07736553MedicaidMS

National Provider Directory

National Provider Directory

Locations

801 Hatchie St
Booneville, MS 38829
Phone (662) 728-2118

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310688000000",
    "number": "1508906223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 930",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388290930",
            "telephone_number": "662-728-2118",
            "fax_number": "662-728-8720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 HATCHIE ST",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388294803",
            "telephone_number": "662-728-2118",
            "fax_number": "662-728-8720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST MISSISSIPPI COMMUNITY SERVICES, INC..",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2011-07-15",
        "status": "A",
        "authorized_official_last_name": "PRESLEY",
        "authorized_official_first_name": "SONIA",
        "authorized_official_title_or_position": "FISCAL OFFICER",
        "authorized_official_telephone_number": "662-728-2118",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07178254",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00770067",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07736553",
            "state": "MS"
        }
    ],
    "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 Jul 15, 2011; 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.