NPIMap

Organization Active NPI

Greenwood Leflore Hospital

  • Emergency Medicine Physician
  • Greenwood, MS
National Provider Identifier
1861670911
Registry record updated May 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
GREENWOOD LEFLORE HOSPITAL
Practice address
1401 River Rd
Greenwood, MS 38930-4030
Phone
(662) 459-2604
NPI assigned
Jan 31, 2008
Organization subpart
Yes
Parent organization
GREENWOOD LEFLORE HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 7, 2018

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

Authorized official

Name
Jennifer Dawne Holmes
Title
Cfo
Phone
(662) 459-2603

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary
Clinical Pathology/Laboratory Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0105X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X

Addresses

Primary practice location

1401 River Rd
Greenwood, MS 38930-4030

Mailing address

PO Box 1410
Greenwood, MS 38935-1410
Phone (662) 459-2604

Other names 1

  • GLH Pro Fees Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040923000500 MS Part B Supplier - Clinic/Group Practice 1153399472 Receives reassigned benefits from 79 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greenwood, MS

National Provider Directory

National Provider Directory
Tax ID family
Greenwood Leflore Hosp6 organizations share this tax ID, including this one
Part of
Greenwood Leflore Hosp

Other organizations with this tax ID 5

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

Other NPIs on the same Medicare enrollment 1

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

Practitioners 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525651200000",
    "number": "1861670911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1410",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389351410",
            "telephone_number": "662-459-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 RIVER RD",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389304030",
            "telephone_number": "662-459-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENWOOD LEFLORE HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREENWOOD LEFLORE HOSPITAL",
        "enumeration_date": "2008-01-31",
        "last_updated": "2018-05-07",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "DAWNE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "662-459-2603"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GLH Pro Fees",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GLH Pro Fees",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenwood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; 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.