NPIMap

Organization Active NPI

Vicksburg Healthcare LLC

  • Clinical Medical Laboratory
  • Vicksburg, MS
National Provider Identifier
1639799430
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
VICKSBURG HEALTHCARE LLC
Practice address
2100 Highway 61 N
Vicksburg, MS 39183-8211
Phone
(601) 883-5000
NPI assigned
Apr 21, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Authorized official

Name
James P Wright
Title
VP Physician Business Services
Phone
(615) 778-1502

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

2100 Highway 61 N
Vicksburg, MS 39183-8211

Mailing address

PO Box 841672
Dallas, TX 75284-1672

Other names 1

  • Merit Health River Region Doing business as

National Provider Directory

National Provider Directory
Tax ID family
River Region5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1587427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587427200000",
    "number": "1639799430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841672",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752841672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 HIGHWAY 61 N",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391838211",
            "telephone_number": "601-883-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICKSBURG HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-21",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "VP PHYSICIAN BUSINESS SERVICES",
        "authorized_official_telephone_number": "615-778-1502"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Merit Health River Region",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vicksburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.