Southeast Mississippi Rural Health Initiative, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.

Doing business as

Lillie Burney Elementry School

Practice address

901 Ida Ave
Hattiesburg, MS 39401-7776

Phone

(601) 545-8700

Fax

(601) 450-2493

NPI assigned

Mar 16, 2006

Last updated

Jun 9, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.As reported in NPPES

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

Authorized official

Name

Janice Robinson

Title

Chief Executive Officer

Phone

(601) 545-8700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lillie Burney Elementry School Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780653188. Details of each certification follow.

• CCN 251939 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 251939

Legal name

SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.

Doing business as

LILLIE BURNEY ELEMENTARY SCHOOL

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Mar 29, 2005

Last certification

Mar 29, 2005

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Enrollment address

901 Ida Ave
Hattiesburg, MS 39401-7776

Tax ID family

Bellevue Elementary59 organizations share this tax ID, including this one

Part of

Bellevue Elementary

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Baxterville School

  dba Baxterville School (K - 8)

  • Federally Qualified Health Center (FQHC)
  • Lumberton, MS
  • NPI 1679157028
  NPD tax ID
• Beaumont Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Beaumont, MS
  • NPI 1831166826
  NPD tax ID
• Bellevue Elementary

  • Federally Qualified Health Center (FQHC)
  • Hattiesburg, MS
  • NPI 1902502453
  NPD tax ID
• Brooklyn Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, MS
  • NPI 1659348076
  NPD tax ID
• Hattiesburg High School and Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Hattiesburg, MS
  • NPI 1760451777
  NPD tax ID
• Lamar County School Clinic

  • Federally Qualified Health Center (FQHC)
  • Purvis, MS
  • NPI 1679147847
  NPD tax ID
• Mary Bethune Alternative School

  • Federally Qualified Health Center (FQHC)
  • Hattiesburg, MS
  • NPI 1790725224
  NPD tax ID
• New Augusta Family Health Center

  • Federally Qualified Health Center (FQHC)
  • New Augusta, MS
  • NPI 1881661874
  NPD tax ID
• Oak Grove Elementary

  dba Oak Grove Elementary School

  • Federally Qualified Health Center (FQHC)
  • Hattiesburg, MS
  • NPI 1588238760
  NPD tax ID
• Oak Grove High School

  • Federally Qualified Health Center (FQHC)
  • Hattiesburg, MS
  • NPI 1790359966
  NPD tax ID
• Perry Central High School

  • Federally Qualified Health Center (FQHC)
  • New Augusta, MS
  • NPI 1740226976
  NPD tax ID
• Perry Central Middle School

  • Federally Qualified Health Center (FQHC)
  • New Augusta, MS
  • NPI 1639115207
  NPD tax ID

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.

All facility ownership & control disclosures 37

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

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780963200000",
    "number": "1780653188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1729",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394031729",
            "telephone_number": "601-545-8700",
            "fax_number": "601-582-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 IDA AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017776",
            "telephone_number": "601-545-8700",
            "fax_number": "601-450-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.",
        "enumeration_date": "2006-03-16",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "601-545-8700"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007058395",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lillie Burney Elementry School",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lillie Burney Elementry School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southeast Mississippi Rural Health Initiative, Inc. (Thames Elementary School)
• Southeast Mississippi Rural Health Initiative, Inc.
• Southeast Mississippi Rural Health Initiative, Inc. (Grace Christian Elementary School)
• Southeast Mississippi Rural Health Initiative, Inc. (North Forrest Attendance Center)
• Southeast Mississippi Rural Health Initiative, Inc. (Hattiesburg Family Health Center)
• Southeast Mississippi Rural Health Initiative, Inc. (Earl Travillion Attendance Center)
• Southeast Mississippi Rural Health Inititive (Pharmacy Assistance Center)
• Southeast Ms Air Ambulance District
• Southern Anesthesia Inc
• Southern Behavioral Medicine Associates PLLC

• Federally Qualified Health Center (FQHC) in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Federally Qualified Health Center (FQHC) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.