Active NPI
Southwest Health Agency for Rural People, Inc.
Doing business as SHARP, Inc
- Community Health Clinic/Center
- Tylertown, MS
National Provider Identifier
1861515587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Clinic/Center
- Legal business name
- SOUTHWEST HEALTH AGENCY FOR RURAL PEOPLE, INC.
- Doing business as
- SHARP, Inc
- Practice address
- 101 Hospital Dr
Tylertown, MS 39667-2021 - Phone
- (601) 876-4926
- Fax
- (601) 876-4333
- NPI assigned
- Apr 9, 2007
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Bernard Simmons
- Title
- Ceo
- Phone
- (601) 876-4926
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Clinic/Center | 261QC1500X | NU | Primary |
Addresses
Primary practice location
101 Hospital Dr
Tylertown, MS 39667-2021
Mailing address
101 Hospital Dr
P.O. Box 32
Tylertown, MS 39667-2021
Phone (601) 876-4926
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09010051 | Medicaid | MS |
Other names 1
- SHARP, Inc
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1861515587. Details of each certification follow.
Federally qualified health center certification: CCN 251828
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- SOUTHWEST HEALTH AGENCY
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Oct 1, 1991
- Last certification
- Oct 1, 1991
- Ownership / control type
- For profit – partnership
- Facility address
- 101 Hospital Dr
Tylertown, MS 39667
National Provider Directory
National Provider Directory- Tax ID family
- Sharp Famity Care Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Sharp Famity Care Center
- Community Health Clinic/Center
- Columbia, MS
- NPI 1144407420
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1861515587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 HOSPITAL DR",
"address_2": "P.O. BOX 32",
"city": "TYLERTOWN",
"state": "MS",
"postal_code": "396672021",
"telephone_number": "601-876-4926",
"fax_number": "601-876-4333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 HOSPITAL DR",
"city": "TYLERTOWN",
"state": "MS",
"postal_code": "396672021",
"telephone_number": "601-876-4926",
"fax_number": "601-876-4333"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHWEST HEALTH AGENCY FOR RURAL PEOPLE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-09",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "SIMMONS",
"authorized_official_first_name": "BERNARD",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "601-876-4926",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "261QC1500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Community Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "09010051",
"state": "MS"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "SHARP, Inc",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Tylertown, MS
- Katherine Elizabeth Schubert, FNP-C
- Smiles Inc P C
- Smith Lab Testing LLC
- Southern Digestive Health Center,LLC
- Southern Remedy Family Medicine
- Southwest Pharmacy Inc (Guy's Pharmacy of Tylertown)
- Sylvia Sessions Stogner, LCSW
- Symphony Respiratory Services (Golden Care of Tylertown)
- Thomas Drug Company (Brumfields Drugs)
- Nutrecia Thompson
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.