NPIMap

Organization Active NPI

North Sunflower Medical Center

  • Critical Access Hospital
  • Ruleville, MS
National Provider Identifier
1508913609
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
11-168 Issued in MS
Legal business name
NORTH SUNFLOWER MEDICAL CENTER
Practice address
840 N Oak Ave
Ruleville, MS 38771-0369
Phone
(662) 756-2711
Fax
(662) 756-4114
NPI assigned
Jan 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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

Authorized official

Name
Mr. Jose Daniel Ceja
Title
Ceo
Phone
(662) 756-2711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 11-168 MS Primary

Addresses

Primary practice location

840 N Oak Ave
Ruleville, MS 38771-0369

Mailing address

PO Box 369
Ruleville, MS 38771-0369
Phone (662) 756-2711

Other identifiers 4

IdentifierTypeStateIssuer
09013431MedicaidMS
09013432MedicaidMS
09013627MedicaidMS
00020118MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080502000610 MS Part A Provider - Critical Access Hospital 7618932294 Receives reassigned benefits from 53 practitioners
Practice locations: Ruleville, MS

Hospital certification: CCN 251318

Legal name
NORTH SUNFLOWER MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 1, 2004
Last certification
Mar 2, 2023
Beds
35
Ownership / control type
Local
Organization structure
OtherNon-profit
Incorporated
Oct 1, 2004 in MS
Enrollment address
840 N Oak Ave
Ruleville, MS 38771-3227

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 10

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

Care Compare: Hospital

Medicare Care Compare
Listed as
North Sunflower Medical Center CahCCN 251318
Overall star rating
1 of 5
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Sunflower Greenwood Clinic19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Locations

840 N Oak Ave
Ruleville, MS 38771
Phone (601) 756-2711

Interoperability endpoints

  • Direct secure messaging: samuelseeley@nsfmc.allscriptsdirect.net
  • Direct secure messaging: michaelbeckum@nsfmc.allscriptsdirect.net
  • Direct secure messaging: benniewright@nsfmc.allscriptsdirect.net
  • Direct secure messaging: kajuandrachandler@nsfmc.allscriptsdirect.net
  • Direct secure messaging: williamhodnett@nsfmc.allscriptsdirect.net
  • Direct secure messaging: katherinesummers@nsfmc.allscriptsdirect.net
  • Direct secure messaging: frederickflowers@nsfmc.allscriptsdirect.net
  • Direct secure messaging: rohithreddy@nsfmc.allscriptsdirect.net
  • Direct secure messaging: meganflint@nsfmc.allscriptsdirect.net
  • Direct secure messaging: angelagibson@nsfmc.allscriptsdirect.net
  • Direct secure messaging: brooksrizzo@nsfmc.allscriptsdirect.net
  • Direct secure messaging: lizevans@nsfmc.allscriptsdirect.net
  • Direct secure messaging: jasonmorris@nsfmc.allscriptsdirect.net
  • Direct secure messaging: amanmunir@nsfmc.allscriptsdirect.net
  • Direct secure messaging: bethanygreco@nsfmc.allscriptsdirect.net
  • Direct secure messaging: waltermoses@nsfmc.allscriptsdirect.net
  • Direct secure messaging: jacquelinebrown@nsfmc.allscriptsdirect.net
  • Direct secure messaging: jameswarrington@nsfmc.allscriptsdirect.net
  • Direct secure messaging: donaldblackwood@nsfmc.allscriptsdirect.net
  • Direct secure messaging: shannonmyers@nsfmc.allscriptsdirect.net

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Samuel Miller Individual Corporate Officer Jul 26, 2015
Operational/Managerial Control Jul 26, 2015
Jose Ceja Individual Corporate OfficerCfo Feb 5, 2020
Corporate DirectorCfo Feb 5, 2020
Kerry Walters Individual Corporate Officer Aug 2, 2012
Operational/Managerial Control Nov 1, 2011 100%
North Sunflower Medical Center Organization, Ruleville, MS Operational/Managerial Control Oct 1, 2004 100%

Owners & managing parties with NPI records 10

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Sunflower Rural Health CenterRuleville, MS, CCN 253400 Rural health clinic Operational/Managerial Control Oct 1, 2014
Sunflower Greenwood ClinicGreenwood, MS, CCN 258686 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 31, 2023

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 71

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

View all 71

Affiliated clinicians 92

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 92

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591574400000",
    "number": "1508913609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 369",
            "city": "RULEVILLE",
            "state": "MS",
            "postal_code": "387710369",
            "telephone_number": "662-756-2711",
            "fax_number": "662-756-4114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 N OAK AVE",
            "city": "RULEVILLE",
            "state": "MS",
            "postal_code": "387710369",
            "telephone_number": "662-756-2711",
            "fax_number": "662-756-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SUNFLOWER MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A",
        "authorized_official_last_name": "CEJA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-756-2711",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "MS",
            "license": "11-168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09013431",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09013432",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09013627",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00020118",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruleville, MS

Sources for this page

Verify at the official NPI Registry.