South Mississippi Regional Center

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

311 Issued in MS

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

Mar 18, 2010

Last updated

Mar 18, 2010By 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

Mrs. Joanna Whaley

Title

Benefit Specialist

Phone

(228) 867-1348

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

South Mississippi Regional Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• South Mississippi Regional

  • Long Term Care Pharmacy
  • Long Beach, MS
  • NPI 1629091616
  NPD tax ID
• South Mississippi Regional Center

  • Intellectual Disabilities Intermediate Care Facility
  • Long Beach, MS
  • NPI 1033143284
  NPD tax ID
• South Mississippi Regional Center

  • Intellectual Disabilities Intermediate Care Facility
  • Long Beach, MS
  • NPI 1578885117
  NPD tax ID

Locations

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

{
    "created_epoch": "1268870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268870400000",
    "number": "1629392774",
    "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": "2010-03-18",
        "last_updated": "2010-03-18",
        "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": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MS",
            "license": "311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "09555710",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Morietta Smith
• Norman Allen Smith, R.PH.
• South Mississippi Regional
• South Mississippi Regional Center
• South Mississippi Regional Center
• Southern Living Assistance Services
• John Stage
• Kevin Stage, LPN
• Kristina Stewart, LPN
• Jamie Rachael Taylor, MABC, PLCP

• Mental Health Clinic/Center (Including Community Mental Health Center) in Long Beach, MS
• Providers in Long Beach, MS by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.

Verify at the official NPI Registry.