NPIMap

Organization Active NPI

Southwest Mississippi Planning and Development District

  • Adult Day Care Clinic/Center
  • Monticello, MS
National Provider Identifier
1811169840
Registry record updated Mar 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
SOUTHWEST MISSISSIPPI PLANNING AND DEVELOPMENT DISTRICT
Practice address
1477 Fe Sellers Highway
Monticello, MS 39654
Phone
(601) 587-0873
Fax
(601) 587-0936
NPI assigned
Mar 31, 2008
Last updated
Mar 31, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2008

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

Authorized official

Name
Wirt L Peterson, EXECUTIVE DIRECTOR
Title
Executive Director
Phone
(601) 446-6044

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X Primary

Addresses

Primary practice location

1477 Fe Sellers Highway
Monticello, MS 39654

Mailing address

100 S Wall St
Natchez, MS 39120-3477
Phone (601) 446-6044

Other identifiers 2

IdentifierTypeStateIssuer
00770314MedicaidMS
00770117MedicaidMS

National Provider Directory

National Provider Directory
Tax ID family
Southwest Mississippi Planning and Development District5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206921600000",
    "number": "1811169840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S WALL ST",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391203477",
            "telephone_number": "601-446-6044",
            "fax_number": "601-384-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1477 FE SELLERS HIGHWAY",
            "city": "MONTICELLO",
            "state": "MS",
            "postal_code": "39654",
            "telephone_number": "601-587-0873",
            "fax_number": "601-587-0936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST MISSISSIPPI PLANNING AND DEVELOPMENT DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-31",
        "last_updated": "2008-03-31",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "WIRT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "601-446-6044",
        "authorized_official_credential": "EXECUTIVE DIRECTOR"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00770314",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00770117",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; 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.