Organization Active NPI

Health Services of South Mississippi LLC

  • Family Medicine Physician
  • Picayune, MS
National Provider Identifier
1740314756
Registry record updated Feb 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HEALTH SERVICES OF SOUTH MISSISSIPPI LLC
Practice address
2274 Highway 43 S
Picayune, MS 39466-8141
Phone
(601) 798-3989
Fax
(601) 798-3964
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2010

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

Authorized official

Name
Sharon Riser
Title
Owner
Phone
(601) 798-3989

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2274 Highway 43 S
Picayune, MS 39466-8141

Mailing address

2274 Highway 43 S
Picayune, MS 39466-8141
Phone (601) 798-3989

Other identifiers 1

IdentifierTypeStateIssuer
09014343MedicaidMS

Other names 1

  • PICAYUNE HEALTH SERVICES Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266278400000",
    "number": "1740314756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2274 HIGHWAY 43 S",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394668141",
            "telephone_number": "601-798-3989",
            "fax_number": "601-798-3964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2274 HIGHWAY 43 S",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394668141",
            "telephone_number": "601-798-3989",
            "fax_number": "601-798-3964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH SERVICES OF SOUTH MISSISSIPPI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2010-02-16",
        "status": "A",
        "authorized_official_last_name": "RISER",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-798-3989"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09014343",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PICAYUNE HEALTH SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Picayune, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2010; 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.