NPIMap

Organization Active NPI

Covington County Hospital

Doing business as Covington Place: Therapy & Counseling

  • Multi-Specialty Clinic/Center
  • Collins, MS
National Provider Identifier
1831895911
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
COVINGTON COUNTY HOSPITAL
Doing business as
Covington Place: Therapy & Counseling
Practice address
1207 S Fir Ave
Collins, MS 39428-3809
Phone
(601) 698-0263
NPI assigned
Feb 1, 2023
Last updated
Apr 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Authorized official

Name
Anissa L Evans
Title
Credentialing Director
Phone
(601) 698-0328

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

1207 S Fir Ave
Collins, MS 39428-3809

Mailing address

PO Box 2499
Collins, MS 39428-2499
Phone (601) 765-2746

Other names 1

  • Covington Place: Therapy & Counseling Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230315002492 MS Part B Supplier - Clinic/Group Practice 4183517253 Receives reassigned benefits from 6 practitioners
Practice locations: Collins, MS

Other NPIs with the same Medicare PAC ID 15

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

View all 15

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2289479Covington Place - Therapy & Counseling1207 S Fir Ave, Collins, MS 39428Certificate of waiverSep 11, 2027

National Provider Directory

National Provider Directory
Tax ID family
Covington Co Hosp15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

1207 S Fir Ave
Collins, MS 39428
Phone (601) 419-7468

Ownership & related parties

All facility ownership & control disclosures 8

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

FacilityTypeRoleSince
Covington County HospitalCollins, MS, CCN 25M325 Hospital 5% Or Greater Direct Ownership Interest Jan 1, 2016
Arrington Living CenterCollins, MS, CCN 255331 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 May 1, 2011
May 1, 2011
Family Medical AssociatesCollins, MS, CCN 253497 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2016
Family Care ExpressCollins, MS, CCN 258562 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2016
Jan 1, 2016
CCH Clinic MageeMagee, MS, CCN 258597 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Mar 1, 2018
Mar 1, 2018
Express Care SumrallSumrall, MS, CCN 258644 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2020
Family Care of MageeMagee, MS, CCN 258662 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 4, 2021
Jan 4, 2021
Family Care Magee Tuscan TowersMagee, MS, CCN 258660 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Sep 1, 2021
Sep 1, 2021

Owned or controlled facilities with NPI records 8

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

Practitioners & affiliated clinicians

Practitioners 6

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": "1675209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681257600000",
    "number": "1831895911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2499",
            "city": "COLLINS",
            "state": "MS",
            "postal_code": "394282499",
            "telephone_number": "601-765-2746",
            "fax_number": "601-640-1944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 S FIR AVE",
            "city": "COLLINS",
            "state": "MS",
            "postal_code": "394283809",
            "telephone_number": "601-698-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVINGTON COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-01",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "ANISSA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALING DIRECTOR",
        "authorized_official_telephone_number": "601-698-0328"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Covington Place: Therapy & Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Covington Place: Therapy & Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Collins, MS

Sources for this page

Verify at the official NPI Registry.