Allegiance Specialty Hospital of Greenville, LLC

Primary specialty

Psychiatric Hospital UnitTaxonomy code 273R00000X

Legal business name

ALLEGIANCE SPECIALTY HOSPITAL OF GREENVILLE, LLC

Practice address

300 S Washington Ave FL 2
Greenville, MS 38701-4719

Phone

(662) 332-7344

Fax

(662) 332-7925

NPI assigned

Aug 23, 2021

Last updated

Aug 23, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

ALLEGIANCE SPECIALTY HOSPITAL OF GREENVILLE, LLCAs reported in NPPES

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

Authorized official

Name

Vearnail Rowe Herzog

Title

Chief Executive Officer

Phone

(662) 332-7344

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS2 enrollments

Enrollment records 2

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1871269480. Details of each certification follow.

• CCN 252013 Hospital · Active · Details
• CCN 25SA13 Hospital · Details

Hospital certification: CCN 252013

Legal name

ALLEGIANCE SPECIALTY HOSPITAL OF GREENVILLE LLC

Certification status

Active

Provider type (POS)

Hospital – Long-term

Participating since

Nov 1, 2011

Last certification

Feb 20, 2025

Beds

69

Ownership / control type

Private (for profit)

Organization structure

LLCProprietary

Incorporated

Jan 1, 2006 in LA

Enrollment address

300 South Washington Avenue, 3Rd Floor
Greenville, MS 38701-4719
Main/Primary Hospital Location

Hospital subgroups

Long-term

Hospital certification: CCN 25SA13

Legal name

ALLEGIANCE SPECIALTY HOSPITAL OF GREENVILLE LLC

Organization structure

LLCProprietary

Enrollment address

300 S Washington Ave
FL 2
Greenville, MS 38701-4719
Hospital Psychiatric Unit

Hospital subgroups

Long-term, Psychiatric unit

Other NPIs with the same Medicare PAC ID 1

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

• Allegiance Specialty Hospital of Greenville, LLC

  • Long Term Care Hospital
  • Greenville, MS
  • NPI 1154560290

  7214129147

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

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

• Allegiance Specialty Hospital of Greenville, LLC

  • Long Term Care Hospital
  • Greenville, MS
  • NPI 1154560290

  O20120125000436

  Same enrollment

Listed as

Allegiance Specialty Hospital of GreenvilleCCN 252013 · All quality measures

Type

Long-term

Ownership

Proprietary

Medicare certification status

ActiveFrom the Provider of Services file

Emergency services

No

Listed as

Allegiance Specialty Hospital of GreenvilleCCN 252013 · All quality measures

Ownership

For profit

Certified

Nov 1, 2011

Medicare certification status

ActiveFrom the Provider of Services file

Beds

39

Part of

Allegiance Specialty Hospital of Greenville LLC

Locations

All disclosed owners & managing parties 10

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Allegiance Specialty Hospital of Greenville, LLC

  • Long Term Care Hospital
  • Greenville, MS
  • NPI 1154560290
  NPPES parent name

Practitioners 4

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.

• Khaled Nadim Abu-Hamdan, M. D.

  • Psychiatry Physician
  • Whitfield, MS
  • NPI 1356482459
  NPD (past)
• John L Herzog Sr., MD

  • Cardiovascular Disease Physician
  • Greenville, MS
  • NPI 1093734949
  NPD (past)
• Jared Kerome Taylor, M.D.

  • Psychiatry Physician
  • Jackson, MS
  • NPI 1154686541
  NPD (past)
• Mohammad Khursheed Anwar, M.D.

  • Psychiatry Physician
  • Kenner, LA
  • NPI 1477723914
  NPD (past)

Affiliated clinicians 4

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

• John L Herzog Sr., MD

  • Cardiovascular Disease Physician
  • Greenville, MS
  • NPI 1093734949

  Long-term care hospital

  Care Compare affiliation
• Parvez Karim, M.D.

  • Internal Medicine Physician
  • Greenville, MS
  • NPI 1275562464

  Long-term care hospital

  Care Compare affiliation
• Jared Kerome Taylor, M.D.

  • Psychiatry Physician
  • Jackson, MS
  • NPI 1154686541

  Long-term care hospital

  Care Compare affiliation
• Mohammad Khursheed Anwar, M.D.

  • Psychiatry Physician
  • Kenner, LA
  • NPI 1477723914

  Long-term care hospital

  Care Compare affiliation

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629676800000",
    "number": "1871269480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S WASHINGTON AVE FL 3",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387014719",
            "telephone_number": "662-332-7344",
            "fax_number": "662-332-7925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S WASHINGTON AVE FL 2",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387014719",
            "telephone_number": "662-332-7344",
            "fax_number": "662-332-7925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEGIANCE SPECIALTY HOSPITAL OF GREENVILLE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALLEGIANCE SPECIALTY HOSPITAL OF GREENVILLE, LLC",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A",
        "authorized_official_last_name": "HERZOG",
        "authorized_official_first_name": "VEARNAIL",
        "authorized_official_middle_name": "ROWE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "662-332-7344"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Air Evac EMS Inc. (Air Evac Lifeteam)
• Anissa Quansha Alexander
• Alexander's Transportation
• Alexandra L Engel, DMD, Ms, PC
• Allegiance Specialty Hospital of Greenville, LLC
• Melody W Allen, RPH
• Alliance Oncology LLC (Alliance Cancer Center - Greenville)
• American Legacy Properties LLC (Legacy Manor Nursing & Rehabilitation Center)
• An Medi-Zen, PLLC (An Medi-Zen)
• Andrew E Abide DMD PA

• Psychiatric Hospital Unit in Greenville, MS
• Providers in Greenville, MS by specialty
• Psychiatric Hospital Unit in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.