NPIMap

Organization Active NPI

Rush Medical Foundation

Doing business as Ochsner Watkins Professional Services

  • Emergency Medicine Physician
  • Quitman, MS
National Provider Identifier
1659599090
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
RUSH MEDICAL FOUNDATION
Doing business as
Ochsner Watkins Professional Services
Practice address
605 S Archusa Ave
Quitman, MS 39355-2331
Phone
(601) 776-9625
Fax
(601) 776-7147
NPI assigned
Apr 23, 2007
Last updated
Apr 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Authorized official

Name
Don Larkin Kennedy
Title
Regional Ceo
Phone
(601) 703-9614

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

605 S Archusa Ave
Quitman, MS 39355-2331

Mailing address

Dept 3027 P O Box 1000
Memphis, TN 38148-3027
Phone (601) 213-3010

Other identifiers 2

IdentifierTypeStateIssuer
000019214OtherMSBCMS
009013228MedicaidMS

Other names 1

  • Ochsner Watkins Professional Services Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031210000541 MS Part B Supplier - Clinic/Group Practice 2567368541 Receives reassigned benefits from 96 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Meridian, MS; Quitman, MS

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744848000000",
    "number": "1659599090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 3027 P O BOX 1000",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381483027",
            "telephone_number": "601-213-3010",
            "fax_number": "601-213-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 S ARCHUSA AVE",
            "city": "QUITMAN",
            "state": "MS",
            "postal_code": "393552331",
            "telephone_number": "601-776-9625",
            "fax_number": "601-776-7147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSH MEDICAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "DON",
        "authorized_official_middle_name": "LARKIN",
        "authorized_official_title_or_position": "REGIONAL CEO",
        "authorized_official_telephone_number": "601-703-9614"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCMS",
            "identifier": "000019214",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009013228",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Ochsner Watkins Professional Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Quitman, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.