Walthall County General Hospital

Primary specialty

Critical Access HospitalTaxonomy code 282NC0060X

License

11-257 Issued in MS

Legal business name

WALTHALL COUNTY GENERAL HOSPITAL

Practice address

100 Hospital Dr
Tylertown, MS 39667-2022

Phone

(601) 876-2122

Fax

(601) 222-0432

NPI assigned

May 25, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jimmy Lin Graves, CHE

Title

Administrator

Phone

(601) 876-2122

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609822659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR",
            "city": "TYLERTOWN",
            "state": "MS",
            "postal_code": "396672022",
            "telephone_number": "601-876-2122",
            "fax_number": "601-222-0432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR",
            "city": "TYLERTOWN",
            "state": "MS",
            "postal_code": "396672022",
            "telephone_number": "601-876-2122",
            "fax_number": "601-222-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTHALL COUNTY GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_middle_name": "LIN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "601-876-2122",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CHE"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "MS",
            "license": "11-257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0020208",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nutrecia Thompson
• Tylertown Surgical Associates
• Walthal Rural Health Clinic (Tylertown Internal Medicine Clinic)
• Walthall County Behavioral Services
• Walthall County General Hospital
• Walthall County General Hospital
• Walthall General Hospital
• Walthall General Hospital
• Walthall General Hospital (Walthall Rural Health Clinic)
• Walthall Rural Health Clinic (Tylertown Health Clinic)

• Critical Access Hospital in Tylertown, MS
• Providers in Tylertown, MS by specialty
• Critical Access Hospital in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.