NPIMap

Organization Active NPI

East Central Mississippi Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, MS
National Provider Identifier
1679529028
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
EAST CENTRAL MISSISSIPPI HEALTH CARE, INC.
Practice address
10330 Road 375
Philadelphia, MS 39350-3249
Phone
(601) 656-0226
Fax
(601) 656-0226
NPI assigned
May 26, 2006
Organization subpart
Yes
Parent organization
EAST CENTRAL MISSISSIPPI HEALTH CARE INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Authorized official

Name
Mrs. Jill Bishop
Title
Ceo
Phone
(601) 625-7140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

10330 Road 375
Philadelphia, MS 39350-3249

Mailing address

PO Box 142
Sebastopol, MS 39359
Phone (601) 625-7140

Other identifiers 3

IdentifierTypeStateIssuer
C02184MedicaidMS
09014178MedicaidMS
DA1146OtherRAILROAD MEDICARE

Other names 1

  • Philadelphia Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040129000363 MS Part B Supplier - Clinic/Group Practice 0941103717 Receives reassigned benefits from 17 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sebastopol, MS; Walnut Grove, MS; Philadelphia, MS; Newton, MS
O20101015000695 MS Part A Provider - Federally Qualified Health Center (FQHC) 0941103717 Practice locations: Philadelphia, MS

Federally qualified health center certification: CCN 251851

Legal name
EAST CENTRAL MISSISSIPPI HEALTH CARE INC
Doing business as
PHILADELPHIA HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 1, 1995
Last certification
Aug 1, 1995
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 4, 1978 in MS
Enrollment address
10330 Rd 375
Philadelphia, MS 39350-3249
Related CCNs
251829

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

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
East Central Ms Health Care3 organizations share this tax ID, including this one
Part of
East Central Ms Health Care

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Eric Adcock Individual Corporate OfficerBoard Member Feb 1, 2022
Georgia L Jones Individual Corporate Officer Feb 1, 2022
Bobbie Sanders Individual Corporate Officer Nov 1, 2008
Justin McDill Individual Corporate Officer Oct 17, 2022
Delia Shepard Individual Corporate OfficerBoard Member May 1, 2008
Denise Hawkins Individual Corporate OfficerBoard Member Feb 1, 2011
Tammy Hunter Individual Corporate OfficerBoard Member Feb 1, 2022
Steve Duett Individual Corporate OfficerBoard Member Jun 1, 1999
Jill Bishop Individual Corporate Director Apr 1, 2004
W-2 Managing EmployeeCeo Apr 1, 2004 100%
Johnny Barnes Individual Corporate OfficerBoard Member Sep 16, 2013
Regina Gardner Individual Corporate OfficerBoard Member Apr 1, 2002
Tammy Plaisance Individual W-2 Managing EmployeeDelegated Official Jun 1, 2009

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
East Central Mississippi Health Care IncNewton, MS, CCN 251031 Federally qualified health center Operational/Managerial Control (100%) Aug 20, 2015

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745452800000",
    "number": "1679529028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 142",
            "city": "SEBASTOPOL",
            "state": "MS",
            "postal_code": "39359",
            "telephone_number": "601-625-7140",
            "fax_number": "601-625-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10330 ROAD 375",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393503249",
            "telephone_number": "601-656-0226",
            "fax_number": "601-656-0226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST CENTRAL MISSISSIPPI HEALTH CARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAST CENTRAL MISSISSIPPI HEALTH CARE INC.",
        "enumeration_date": "2006-05-26",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A",
        "authorized_official_last_name": "BISHOP",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-625-7140",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C02184",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09014178",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA1146",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Philadelphia Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, MS

Sources for this page

Verify at the official NPI Registry.