NPIMap

Organization Active NPI

Southwest Mississippi Regional Medical Center

Doing business as Summit Family Practice

  • Primary Care Clinic/Center
  • Summit, MS
National Provider Identifier
1841909371
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER
Doing business as
Summit Family Practice
Practice address
802 W Railroad Ave
Summit, MS 39666-9489
Phone
(601) 250-4420
Fax
(601) 250-4421
NPI assigned
Nov 23, 2022
Last updated
Nov 23, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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

Authorized official

Name
Charla Rowley
Title
Ceo
Phone
(601) 249-1806

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

802 W Railroad Ave
Summit, MS 39666-9489

Mailing address

PO Box 490
McComb, MS 39649-0490
Phone (601) 250-4366

Other names 1

  • Summit Family Practice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080512000004 MS Part B Supplier - Clinic/Group Practice 5193633907 Receives reassigned benefits from 86 practitioners
28 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: McComb, MS; Summit, MS; Monticello, MS

Other NPIs on the same Medicare enrollment 22

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 22

National Provider Directory

National Provider Directory
Tax ID family
Smrmc Dba SW Internal M35 organizations share this tax ID, including this one
Part of
Smrmc Dba SW Internal M

Other organizations with this tax ID 34

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

View all 34

Locations

1506 Aston Ave
McComb, MS 39648
Phone (601) 249-4282

215 Marion Ave
McComb, MS 39648
Phone (601) 249-1180

Practitioners & affiliated clinicians

Practitioners 7

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": "1669161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669161600000",
    "number": "1841909371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396490490",
            "telephone_number": "601-250-4366",
            "fax_number": "601-250-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 W RAILROAD AVE",
            "city": "SUMMIT",
            "state": "MS",
            "postal_code": "396669489",
            "telephone_number": "601-250-4420",
            "fax_number": "601-250-4421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER",
        "enumeration_date": "2022-11-23",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A",
        "authorized_official_last_name": "ROWLEY",
        "authorized_official_first_name": "CHARLA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-249-1806"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Summit, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.