NPIMap

Organization Active NPI

Copiah County Medical Center

Doing business as CCMC Hazlehurst Rural Health Clinic

  • Rural Health Clinic/Center
  • Hazlehurst, MS
National Provider Identifier
1629937297
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
COPIAH COUNTY MEDICAL CENTER
Doing business as
CCMC Hazlehurst Rural Health Clinic
Practice address
27190 Highway 28
Hazlehurst, MS 39083-2200
Phone
(601) 574-7000
NPI assigned
Jan 20, 2026
Last updated
Jan 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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

Authorized official

Name
Kortney Michele Gaddy
Title
Cfo
Phone
(601) 574-7200

Specialties & licenses 1

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

Addresses

Primary practice location

27190 Highway 28
Hazlehurst, MS 39083-2200

Mailing address

27190 Highway 28
Hazlehurst, MS 39083-2200

Other names 1

  • CCMC Hazlehurst Rural Health Clinic Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D0317528Hazlehurst Clinic27190 Highway 28, Ste 102, Hazlehurst, MS 39083Certificate of waiverMar 3, 2028

National Provider Directory

National Provider Directory
Tax ID family
Kliesch Med Assoc PA7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1768867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768867200000",
    "number": "1629937297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27190 HIGHWAY 28",
            "city": "HAZLEHURST",
            "state": "MS",
            "postal_code": "390832200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27190 HIGHWAY 28",
            "city": "HAZLEHURST",
            "state": "MS",
            "postal_code": "390832200",
            "telephone_number": "601-574-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPIAH COUNTY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-20",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A",
        "authorized_official_last_name": "GADDY",
        "authorized_official_first_name": "KORTNEY",
        "authorized_official_middle_name": "MICHELE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "601-574-7200"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCMC Hazlehurst Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hazlehurst, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.