Screven County Hospital LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

SCREVEN COUNTY HOSPITAL LLC

Practice address

618 Frederick Dr
Cleveland, MS 38732-2006

Phone

(662) 299-2999

NPI assigned

Jul 2, 2026

Last updated

Jul 2, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

SCREVEN COUNTY HOSPITAL LLCAs reported in NPPES

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

Authorized official

Name

David Alex Villa

Title

Ceo

Phone

(912) 644-3340

Specialties & licenses 1

Addresses

Tax ID family

Screven County Hospital LLC2 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.

• Screven County Hospital LLC

  dba Optim Medical Center - Screven

  • Medicare Defined Swing Bed Hospital Unit
  • Sylvania, GA
  • NPI 1083915524
  NPD tax ID

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

{
    "created_epoch": "1782950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782950400000",
    "number": "1699692319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 MALL BLVD STE C",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 FREDERICK DR",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322006",
            "telephone_number": "662-299-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCREVEN COUNTY HOSPITAL LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SCREVEN COUNTY HOSPITAL LLC",
        "enumeration_date": "2026-07-02",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A",
        "authorized_official_last_name": "VILLA",
        "authorized_official_first_name": "DAVID ALEX",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-644-3340"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reginald L. Rodges, D.C.
• Robert Kim Rushing
• Elizabeth Rustom, DPT
• Jillian Sbravati
• Christian D. Schunn, M.D.
• Serenity Adult Day Care
• Serenity Hospice
• Jack Bittell Sewell, M.D.
• Cassandra Latasha Shepard, FNP
• Covonda Lacraye Shepard

• Diagnostic Radiology Physician in Cleveland, MS
• Providers in Cleveland, MS by specialty
• Diagnostic Radiology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; 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.