NPIMap

Organization Active NPI

Tippah County Hospital

  • Diagnostic Radiology Physician
  • Ripley, MS
National Provider Identifier
1891720009
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
11-159 Issued in MS
Legal business name
TIPPAH COUNTY HOSPITAL
Practice address
1005 City Avenue North
Ripley, MS 38663-0499
Phone
(662) 837-9221
Fax
(662) 837-2110
NPI assigned
Jul 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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

Authorized official

Name
Thomas R Hood
Title
Ceo
Phone
(662) 837-9221

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X 11-159 MS Primary

Addresses

Primary practice location

1005 City Avenue North
Ripley, MS 38663-0499

Mailing address

PO Box 499
Ripley, MS 38663-0499
Phone (662) 837-9221

Other identifiers 2

IdentifierTypeStateIssuer
000019111OtherMSBLUE CROSS
09013601MedicaidMS

Other names 1

  • Tippah County Health Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051212000167 MS Part B Supplier - Clinic/Group Practice 5193746709 Receives reassigned benefits from 47 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ripley, MS; Walnut, MS

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
Tippah County Hospital11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

1005 City Ave N
Ripley, MS 38663
Phone (601) 837-9221

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263945600000",
    "number": "1891720009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 499",
            "city": "RIPLEY",
            "state": "MS",
            "postal_code": "386630499",
            "telephone_number": "662-837-9221",
            "fax_number": "662-837-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 CITY AVENUE NORTH",
            "city": "RIPLEY",
            "state": "MS",
            "postal_code": "386630499",
            "telephone_number": "662-837-9221",
            "fax_number": "662-837-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIPPAH COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2010-01-20",
        "status": "A",
        "authorized_official_last_name": "HOOD",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-837-9221"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "11-159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000019111",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09013601",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tippah County Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ripley, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; 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.