NPIMap

Organization Active NPI

Boa Vida Hospital of Aberdeen, Ms LLC

  • Rural Health Clinic/Center
  • Columbus, MS
National Provider Identifier
1659844405
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BOA VIDA HOSPITAL OF ABERDEEN, MS LLC
Practice address
505 Willowbrook Rd
Columbus, MS 39705-2016
Phone
(662) 329-9191
NPI assigned
Jan 4, 2019
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Kirnjot Singh, MD
Title
President
Phone
(219) 228-4355

Facilities connected through Provider of Services related, parent or unit certification numbers.

Facilities with the same owner 23

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 23

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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
25D0895732MRH Medical Group Primary Care & Women'S Wellness505 Willowbrook Road, Columbus, MS 39705Certificate of waiverNov 1, 2027

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190221000294 MS Part a Provider - Rural Health Clinic 0244505840 Practice locations: Columbus, MS

Rural health clinic certification: CCN 258633

Medicare enrollment files
Legal name
BOA VIDA HOSPITAL OF ABERDEEN MS LLC
Doing business as
MRH MEDICAL GROUP, PRIMARY CARE AND WOMEN'S WELLNESS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 31, 2019
Last certification
Oct 31, 2019
Ownership / control type
1B
Organization structure
LLCProprietary
Enrollment address
505 Willowbrook Rd
Columbus, MS 39705-2016
Related CCNs
251302

All disclosed owners & managing parties 3

Medicare enrollment files

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Boa Vida Hospital of Aberdeen Ms LLC Organization, Aberdeen, MS Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Oct 1, 2017 100%
Operational/Managerial Control Oct 1, 2017 100%
Jennie Lankhorst Individual W-2 Managing EmployeeDirector, Payor Contracting & Crede Apr 20, 2024
Kirnjot Singh Individual Contracted Managing EmployeePresident Oct 1, 2017 99%
Corporate OfficerPresident Oct 1, 2017 99%

All facility ownership & control disclosures 23

Medicare enrollment files

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Monroe Regional HospitalAberdeen, MS, CCN 251302 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2017
Oct 1, 2017
Monroe Regional HospitalAberdeen, MS, CCN 25Z302 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2017
Oct 1, 2017
Monroe Regional HospitalAberdeen, MS, CCN 25M302 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2017
MRH Medical Group JurneyAberdeen, MS, CCN 258537 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2017
Monroe Regional HospitalAberdeen, MS, CCN 258975 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2017
MRH Medical GroupAberdeen, MS, CCN 258515 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2017
Oct 1, 2017
MRH Medical Group HamiltonHamilton, MS, CCN 258521 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2017
Oct 1, 2017
MRH Medical Group, Columbus 5TH St.Columbus, MS, CCN 258635 Rural health clinic 5% Or Greater Direct Ownership Interest (99%) Oct 1, 2017
Monroe Regional HospitalSherman, MS, CCN 258647 Rural health clinic 5% Or Greater Direct Ownership Interest (99%) Oct 1, 2017
Monroe Regional HospitalAmory, MS, CCN 258634 Rural health clinic 5% Or Greater Direct Ownership Interest (99%) Oct 1, 2017
MRH Medical Group, West PointWest Point, MS, CCN 258638 Rural health clinic 5% Or Greater Direct Ownership Interest Oct 1, 2017
MRH Medical Group, Corinth Alcorn Dr.Corinth, MS, CCN 258639 Rural health clinic 5% Or Greater Direct Ownership Interest Oct 1, 2017
MRH Medical Group, NettletonNettleton, MS, CCN 258636 Rural health clinic 5% Or Greater Direct Ownership Interest (99%) Oct 1, 2017
MRH Medical Group, BelmontBelmont, MS, CCN 258637 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2017
MRH Medical Group, GSV HoulkaNew Houlka, MS, CCN 258646 Rural health clinic 5% Or Greater Direct Ownership Interest (99%) Oct 1, 2017
Monroe Regional HospitalPontotoc, MS, CCN 258657 Rural health clinic 5% Or Greater Direct Ownership Interest (99%) Oct 1, 2017
MRH Medical Group East Main Family MedicalTupelo, MS, CCN 258658 Rural health clinic 5% Or Greater Direct Ownership Interest (99%) Oct 1, 2017
MRH Medical Group Premier Diabetes and Medical ClinicBelden, MS, CCN 258656 Rural health clinic 5% Or Greater Direct Ownership Interest (99%) Oct 1, 2017
MRH Medical Group, StarkvilleStarkville, MS, CCN 258666 Rural health clinic 5% Or Greater Direct Ownership Interest (99%) Oct 1, 2017
MRH Medical Group, Verona Family Medicine & Urgent CareTupelo, MS, CCN 258659 Rural health clinic 5% Or Greater Direct Ownership Interest (99%) Oct 1, 2017
MRH Medical Group Potter Family ClinicGreenville, MS, CCN 258668 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2017
MRH Medical Group Horn Medical ClinicHouston, MS, CCN 258667 Rural health clinic 5% Or Greater Direct Ownership Interest (99%) Oct 1, 2017
MRH Medical Group Rice Family Medical ClinicCalhoun City, MS, CCN 258669 Rural health clinic 5% Or Greater Direct Ownership Interest (99%) Oct 1, 2017

National Provider Directory

National Provider Directory
Tax ID family
Boa Vida Hospital Aberdeen36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

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

View all 35

Locations

505 Willowbrook Rd
Columbus, MS 39705
Phone (662) 329-9191

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

Primary practice location

505 Willowbrook Rd
Columbus, MS 39705-2016

Mailing address

10996 Four Seasons PL Ste 100C
Crown Point, IN 46307-7762
Phone (219) 228-1021

Other names 1

NPPES NPI Registry
  • MRH Medical Group, Primary Care and Women's Wellness Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 17, 2024.

{
    "created_epoch": "1546560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1659844405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10996 FOUR SEASONS PL STE 100C",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077762",
            "telephone_number": "219-228-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 WILLOWBROOK RD",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397052016",
            "telephone_number": "662-329-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOA VIDA HOSPITAL OF ABERDEEN, MS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-04",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A",
        "authorized_official_last_name": "SINGH",
        "authorized_official_first_name": "KIRNJOT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-228-4355",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MRH Medical Group, Primary Care and Women's Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, MS

Sources for this page

Verify at the official NPI Registry.