Active NPI
South Mississippi Regional Center
- Intellectual Disabilities Intermediate Care Facility
- Long Beach, MS
National Provider Identifier
1578885117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual Disabilities Intermediate Care Facility
- License
- 311
- Legal business name
- SOUTH MISSISSIPPI REGIONAL CENTER
- Practice address
- 1170 W Railroad St
Long Beach, MS 39560-4106 - Phone
- (228) 867-1348
- Fax
- (228) 214-5563
- NPI assigned
- Feb 24, 2010
- Last updated
- Feb 24, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Joanna Whaley
- Title
- Benefit Specialist
- Phone
- (228) 867-1348
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 311 | MS | Primary |
Addresses
Primary practice location
1170 W Railroad St
Long Beach, MS 39560-4106
Mailing address
1170 W Railroad St
Long Beach, MS 39560-4106
Phone (228) 867-1348
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00770072 | Other | MS | PROVIDER NUMBER |
National Provider Directory
National Provider Directory- Tax ID family
- South Mississippi Regional Center
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Long Beach, MS
- NPI 1629091616
-
- Intellectual Disabilities Intermediate Care Facility
- Long Beach, MS
- NPI 1033143284
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Long Beach, MS
- NPI 1629392774
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266969600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1266969600000",
"number": "1578885117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1170 W RAILROAD ST",
"city": "LONG BEACH",
"state": "MS",
"postal_code": "395604106",
"telephone_number": "228-867-1348",
"fax_number": "228-214-5563"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1170 W RAILROAD ST",
"city": "LONG BEACH",
"state": "MS",
"postal_code": "395604106",
"telephone_number": "228-867-1348",
"fax_number": "228-214-5563"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTH MISSISSIPPI REGIONAL CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2010-02-24",
"last_updated": "2010-02-24",
"status": "A",
"authorized_official_last_name": "WHALEY",
"authorized_official_first_name": "JOANNA",
"authorized_official_title_or_position": "BENEFIT SPECIALIST",
"authorized_official_telephone_number": "228-867-1348",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "315P00000X",
"taxonomy_group": "",
"desc": "Intermediate Care Facility, Intellectual Disabilities",
"state": "MS",
"license": "311",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER NUMBER",
"identifier": "00770072",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.