NPIMap

Organization Active NPI

Pioneer Health Services of Monroe County, Inc

Doing business as Nina Jurney Family Medical Practice

  • Rural Health Clinic/Center
  • Aberdeen, MS
National Provider Identifier
1790864577
Registry record updated Feb 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
PIONEER HEALTH SERVICES OF MONROE COUNTY, INC
Doing business as
Nina Jurney Family Medical Practice
Practice address
502 Jackson St Ste 4
Aberdeen, MS 39730-3300
Phone
(601) 369-9945
Fax
(662) 304-4007
NPI assigned
Nov 3, 2006
Last updated
Feb 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2008

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

Authorized official

Name
Mr. Joseph S McNulty III, CRT
Title
President
Phone
(601) 849-6440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

502 Jackson St Ste 4
Aberdeen, MS 39730-3300

Mailing address

PO Box 1100
Magee, MS 39111-1100
Phone (601) 849-6440

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidMS

Other names 1

  • Nina Jurney Family Medical Practice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Oct 1, 2017 Change of OwnershipThis provider was the seller MRH Medical Group JurneyCCN 258537, MS, NPI 1245757319

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202860800000",
    "number": "1790864577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1100",
            "city": "MAGEE",
            "state": "MS",
            "postal_code": "391111100",
            "telephone_number": "601-849-6440",
            "fax_number": "601-849-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 JACKSON ST STE 4",
            "city": "ABERDEEN",
            "state": "MS",
            "postal_code": "397303300",
            "telephone_number": "601-369-9945",
            "fax_number": "662-304-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER HEALTH SERVICES OF MONROE COUNTY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2008-02-13",
        "status": "A",
        "authorized_official_last_name": "MCNULTY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-849-6440",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "CRT"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nina Jurney Family Medical Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aberdeen, MS

Sources for this page

Verify at the official NPI Registry.