NPIMap

Organization Active NPI

Neshoba County General Hospital

  • Skilled Nursing Facility
  • Philadelphia, MS
National Provider Identifier
1841325545
Registry record updated Sep 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
177 Issued in MS
Legal business name
NESHOBA COUNTY GENERAL HOSPITAL
Practice address
1001 Holland Ave
Philadelphia, MS 39350-2161
Phone
(601) 663-1200
Fax
(601) 663-1236
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2009

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

Authorized official

Name
Roger Cole
Title
Administrator
Phone
(601) 663-1445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 177 MS Primary

Addresses

Primary practice location

1001 Holland Ave
Philadelphia, MS 39350-2161

Mailing address

1001 Holland Ave
Philadelphia, MS 39350-2161
Phone (601) 663-1200

Other identifiers 1

IdentifierTypeStateIssuer
00023106MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091120000372 MS Part A Provider - Skilled Nursing Facility 6204738289 Practice locations: Philadelphia, MS

Skilled nursing facility certification: CCN 255137

Legal name
NESHOBA COUNTY GENERAL HOSPITAL
Doing business as
NESHOBA COUNTY GENERAL HOSPITAL-NURSING HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 20, 1991
Last certification
Dec 15, 2023
Beds
145
Ownership / control type
County
Organization structure
OtherNon-profit
Enrollment address
1001 Holland Ave
Philadelphia, MS 39350-2161
Nursing home name
NESHOBA COUNTY NURSING HOME

Other NPIs with the same Medicare PAC ID 6

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Neshoba County Nursing HomeCCN 255137
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Government - County
Certified
May 20, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
145128.9 residents per day on average
Penalties (3 years)
1Fines totaling $15,945

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Ms Neurodiagnostic Lab16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

215 Hospital Rd E
Philadelphia, MS 39350

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Marshall Posey Individual Operational/Managerial Control Apr 20, 2016
Trustee of the SNF Apr 20, 2016
Jo Helen Daly Individual Trustee of the SNF Dec 15, 2011
Ruby Brazzle Individual Trustee of the SNF Dec 5, 2011
Oliver Jolly Individual Trustee of the SNF Sep 16, 2009
Stefani Rohani Marie Beale Individual Adp of the SNF Apr 14, 2025
Neshoba County General Hospital Organization, Philadelphia, MS Non-profit Operational/Managerial Control Oct 22, 2009 100%
Adp of the SNF Oct 22, 2009
Direct Ownership Interest Oct 22, 2009 100%
Dale Joyner Individual Trustee of the SNF Jan 15, 2020
Glenda Shay Ward Individual 5% Or Greater Indirect Ownership Interest Aug 1, 2024
Adp of the SNF Feb 10, 2025
Scott McNair Individual Corporate OfficerCfo Jan 1, 2016 100%

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Neshoba County General HospitalPhiladelphia, MS, CCN 25U043 Hospital Operational/Managerial Control (100%) May 1, 2009
Neshoba County General Hospital Psych UnitPhiladelphia, MS, CCN 25S043 Hospital Operational/Managerial Control May 1, 2009
Neshoba County General HospitalPhiladelphia, MS, CCN 25Z340 Hospital Operational/Managerial Control Jan 1, 2025
Neshoba County General HospitalPhiladelphia, MS, CCN 251340 Hospital Operational/Managerial Control Jan 1, 2025
Neshoba Medical AssociatesPhiladelphia, MS, CCN 258559 Rural health clinic Other (100%) Apr 1, 2012

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254096000000",
    "number": "1841325545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 HOLLAND AVE",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502161",
            "telephone_number": "601-663-1200",
            "fax_number": "601-663-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 HOLLAND AVE",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502161",
            "telephone_number": "601-663-1200",
            "fax_number": "601-663-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NESHOBA COUNTY GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2009-09-28",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "601-663-1445"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MS",
            "license": "177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00023106",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, MS

Sources for this page

Verify at the official NPI Registry.