NPIMap

Organization Active NPI

Neshoba County General Hospital

  • Rural Health Clinic/Center
  • Philadelphia, MS
National Provider Identifier
1528295532
Registry record updated Aug 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
258560 Issued in MS
Legal business name
NESHOBA COUNTY GENERAL HOSPITAL
Practice address
1120 E Main St
Suite 1
Philadelphia, MS 39350-2300
Phone
(601) 656-1465
Fax
(601) 656-2752
NPI assigned
Jun 17, 2009
Organization subpart
Yes
Parent organization
NESHOBA COUNTY GENERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 3, 2017

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

Authorized official

Name
Mr. Scott McNair
Title
Cfo
Phone
(601) 663-1233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 258560 MS Primary

Addresses

Primary practice location

1120 E Main St
Suite 1
Philadelphia, MS 39350-2300

Mailing address

1120 E Main St
Suite 1
Philadelphia, MS 39350-2300
Phone (601) 656-1465

Other identifiers 1

IdentifierTypeStateIssuer
07788305MedicaidMS

Other names 1

  • Neshoba Urgent Care-Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110224000755 MS Part A Provider - Rural Health Clinic 6204738289 Practice locations: Philadelphia, MS

Rural health clinic certification: CCN 258560

Legal name
NESHOBA COUNTY GENERAL HOSPITAL
Doing business as
NESHOBA URGENT CARE CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 12, 2012
Last certification
Dec 11, 2018
Ownership / control type
2B
Organization structure
GovernmentNon-profit
Enrollment address
1120 E Main St, Ste 1
Neshoba Urgent Care Clinic
Philadelphia, MS 39350-2300
Related CCNs
250043

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Part of
Ms Neurodiagnostic Lab

Locations

1120 E Main St
Ste 1
Philadelphia, MS 39350
Phone (601) 656-1465

Interoperability endpoints

  • Direct secure messaging: shannonkirkland@neshobahealth.cernerdirect.com
  • Direct secure messaging: donaldguild@neshobahealth.cernerdirect.com
  • Direct secure messaging: bobbysmith@neshobahealth.cernerdirect.com
  • Direct secure messaging: jessicastokes@neshobahealth.cernerdirect.com

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Gary L McCall Individual Corporate OfficerCeo Oct 1, 2014 100%
W-2 Managing EmployeeCeo Oct 1, 2014 100%
Scott McNair Individual Corporate OfficerCfo Oct 1, 2014 100%
W-2 Managing EmployeeCfo Oct 1, 2014 100%

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Neshoba County General HospitalPhiladelphia, MS, CCN 25U043 Hospital Operational/Managerial Control (100%) May 1, 2009
Neshoba County General Hospital Psych UnitPhiladelphia, MS, CCN 25S043 Hospital Operational/Managerial Control May 1, 2009
Neshoba County General HospitalPhiladelphia, MS, CCN 25Z340 Hospital Operational/Managerial Control Jan 1, 2025
Neshoba County General HospitalPhiladelphia, MS, CCN 251340 Hospital Operational/Managerial Control Jan 1, 2025
Neshoba County General Hospital-Nursing HomePhiladelphia, MS, CCN 255137 Skilled nursing facility Operational/Managerial Control (100%)
Adp of the SNF
Direct Ownership Interest (100%)		 Oct 22, 2009
Oct 22, 2009
Oct 22, 2009
Neshoba Medical AssociatesPhiladelphia, MS, CCN 258559 Rural health clinic Other (100%) Apr 1, 2012

Owned or controlled facilities with NPI records 5

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

Practitioners & affiliated clinicians

Practitioners 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501718400000",
    "number": "1528295532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 E MAIN ST",
            "address_2": "SUITE 1",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502300",
            "telephone_number": "601-656-1465",
            "fax_number": "601-656-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 E MAIN ST",
            "address_2": "SUITE 1",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502300",
            "telephone_number": "601-656-1465",
            "fax_number": "601-656-2752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NESHOBA COUNTY GENERAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NESHOBA COUNTY GENERAL HOSPITAL",
        "enumeration_date": "2009-06-17",
        "last_updated": "2017-08-03",
        "status": "A",
        "authorized_official_last_name": "MCNAIR",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "601-663-1233",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MS",
            "license": "258560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07788305",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neshoba Urgent Care-Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, MS

Sources for this page

Verify at the official NPI Registry.