NPIMap

Organization Active NPI

Magnolia Regional Health Center

Doing business as Magnolia Primary Care - Michie Tennessee

  • General Practice Physician
  • Michie, TN
National Provider Identifier
1790533586
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MAGNOLIA REGIONAL HEALTH CENTER
Doing business as
Magnolia Primary Care - Michie Tennessee
Practice address
6659 Michie Pebble Hill Rd
Michie, TN 38357-5115
Phone
(731) 227-5211
Fax
(731) 227-5212
NPI assigned
May 8, 2024
Last updated
May 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Authorized official

Name
James Hobson
Title
Ceo
Phone
(662) 293-7664

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

6659 Michie Pebble Hill Rd
Michie, TN 38357-5115

Mailing address

401 Alcorn Dr Ste 2C
Corinth, MS 38834-9073
Phone (662) 293-1553

Other names 1

  • Magnolia Primary Care - Michie Tennessee Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240620002237 TN Part B Supplier - Clinic/Group Practice 9739078460 Receives reassigned benefits from 1 practitioner
Practice locations: Michie, TN

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
Magnolia Regional Healt18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Ownership & related parties

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Magnolia Regional Health CenterCorinth, MS, CCN 250009 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jul 1, 1966
Jul 1, 1966
Magnolia Regional Health Center - Behavioral HealthCorinth, MS, CCN 25S009 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Oct 1, 1992
Oct 1, 1992
Magnolia Express CareCorinth, MS, CCN 258689 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Nov 1, 2024
Nov 1, 2024
Magnolia Women's ClinicCorinth, MS, CCN 258690 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Nov 1, 2024
Nov 1, 2024
Magnolia Pediatric ClinicCorinth, MS, CCN 258691 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Nov 1, 2024
Nov 1, 2024

Owned or controlled facilities with NPI records 6

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1715126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1790533586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 ALCORN DR STE 2C",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349073",
            "telephone_number": "662-293-1553",
            "fax_number": "662-293-7696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6659 MICHIE PEBBLE HILL RD",
            "city": "MICHIE",
            "state": "TN",
            "postal_code": "383575115",
            "telephone_number": "731-227-5211",
            "fax_number": "731-227-5212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA REGIONAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-08",
        "last_updated": "2024-05-08",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "HOBSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-293-7664"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Primary Care - Michie Tennessee",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Michie, TN

Sources for this page

Verify at the official NPI Registry.