South Mississippi State Hospital

Primary specialty

Institutional PharmacyTaxonomy code 3336I0012X

License

04871/3.1 Issued in MS

Legal business name

SOUTH MISSISSIPPI STATE HOSPITAL

Doing business as

South Mississippi State Hospital

Practice address

823 Highway 589
Purvis, MS 39475-4194

Phone

(601) 794-0201

Fax

(601) 794-0220

NPI assigned

Jan 3, 2007

Last updated

Nov 2, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Clint Ashley

Title

Hospital Director

Phone

(601) 794-0152

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• SOUTH MISSISSIPPI STATE HOSPITAL Doing business as

Tax ID family

South Mississippi State2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• South Mississippi State Hospital

  • Psychiatric Hospital Unit
  • Purvis, MS
  • NPI 1457330995
  NPD tax ID

Locations

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478044800000",
    "number": "1679630008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 HIGHWAY 589",
            "city": "PURVIS",
            "state": "MS",
            "postal_code": "394754194",
            "telephone_number": "601-794-0201",
            "fax_number": "601-794-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 HIGHWAY 589",
            "city": "PURVIS",
            "state": "MS",
            "postal_code": "394754194",
            "telephone_number": "601-794-0201",
            "fax_number": "601-794-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH MISSISSIPPI STATE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2016-11-02",
        "status": "A",
        "authorized_official_last_name": "ASHLEY",
        "authorized_official_first_name": "CLINT",
        "authorized_official_title_or_position": "HOSPITAL DIRECTOR",
        "authorized_official_telephone_number": "601-794-0152"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "MS",
            "license": "04871/3.1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2046299",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH MISSISSIPPI STATE HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Allison Smith, LMSW
• Joyce Ann Smith, PT, DPT
• Kaylee C Smith, PCMHT
• Kimberly J Smith, CCSS
• South Mississippi State Hospital
• Mitzi Crawford Spears, LCSW
• William Spears, PHD
• Jamila Annice Spinks, PMHNP
• Justin Starnes, DMD
• Kristi L Stewart, PCMHT

• Institutional Pharmacy in Purvis, MS
• Providers in Purvis, MS by specialty
• Institutional Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.