South Mississippi Medical Supply and Veterans Serivces, LLC

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

SOUTH MISSISSIPPI MEDICAL SUPPLY AND VETERANS SERIVCES, LLC

Practice address

271 F E Sellers Hwy
Monticello, MS 39654-9556

Phone

(016) 806-5046

Fax

(601) 806-5048

NPI assigned

May 17, 2019

Organization subpart

No

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

Authorized official

Name

Hampshire C Collins

Title

Owner/President

Phone

(601) 596-4175

Specialties & licenses 1

Addresses

Other names 1

• South MS Medical Supply Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

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

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639526400000",
    "number": "1821654526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1527",
            "city": "MONTICELLO",
            "state": "MS",
            "postal_code": "396541527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 F E SELLERS HWY",
            "city": "MONTICELLO",
            "state": "MS",
            "postal_code": "396549556",
            "telephone_number": "016-806-5046",
            "fax_number": "601-806-5048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH MISSISSIPPI MEDICAL SUPPLY AND VETERANS SERIVCES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-17",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "HAMPSHIRE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "601-596-4175"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South MS Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South MS Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Molly Grace Ready Sasser, NP-C
• Sherry Chance Pippen, DMD, PA
• Amanda Rose Smith, FNP-C
• Austin Smith, OT
• Shannon Smith
• Southwest Mississippi Planning and Development District
• Southwest Mississippi Regional Medical Center
• Southwest Mississippi Regional Medical Center
• Southwest Mississippi Regional Medical Center
• Southwest Mississippi Regional Medical Center

• All providers in Monticello, MS
• Oxygen Equipment & Supplies (DME) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.