NPIMap

Organization Active NPI

Sharkey-Issaquena Community Hospital

Doing business as Sharkey Issaquena Nursing Home

  • Skilled Nursing Facility
  • Rolling Fork, MS
National Provider Identifier
1922056050
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
539 Issued in MS
Legal business name
SHARKEY-ISSAQUENA COMMUNITY HOSPITAL
Doing business as
Sharkey Issaquena Nursing Home
Sharkey-Issaquena Nursing Home
Practice address
431 West Race Street
Rolling Fork, MS 39159
Phone
(662) 873-6218
Fax
(662) 873-6050
NPI assigned
May 4, 2006
Last updated
Jan 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Authorized official

Name
Mr. Steven G. Keever
Title
Administrator
Phone
(662) 873-4395

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 539 MS Primary

Addresses

Primary practice location

431 West Race Street
Rolling Fork, MS 39159

Mailing address

431 West Race Street
Rolling Fork, MS 39159
Phone (662) 873-6218

Other identifiers 2

IdentifierTypeStateIssuer
80489OtherMSBLUE CROSS BLUE SHIELD
00230129MedicaidMS

Other names 2

  • Sharkey Issaquena Nursing Home Doing business as
  • Sharkey-Issaquena Nursing Home Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160415001085 MS Part A Provider - Skilled Nursing Facility 1759283039 Practice locations: Rolling Fork, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922056050. Details of each certification follow.

Skilled nursing facility certification: CCN 255220

Legal name
SHARKEY ISSAQUENA COMMUNITY HOSPITAL
Doing business as
SHARKEY ISSAQUENA NURSING HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1996
Last certification
Oct 3, 2024
Beds
54
Ownership / control type
County
Organization structure
OtherNon-profit
Incorporated
Oct 6, 2006 in MS
Enrollment address
431 West Race Street
Rolling Fork, MS 39159-2625
Nursing home name
SHARKEY-ISSAQUENA NURSING HOME

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Sharkey-Issaquena Nursing HomeCCN 255220 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Government - County
Certified
Jan 1, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5449.2 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D0675854Sharkey Issaquena Nursing Home431 W Race St, Rolling Fork, MS 39159Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Sharkey Issaquena Comm Hosp-ER7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

431 W Race St
Rolling Fork, MS 39159
Phone (662) 795-0440

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/sharkey-950b444e

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Steven G Keever Individual Corporate OfficerAdministrator Ceo Jan 1, 2016 100%
Operational/Managerial Control Mar 24, 2025
Sharkey Issaquena Community Hospital Organization, Rolling Fork, MS 5% Or Greater Direct Ownership Interest Jan 1, 2016 100%
Operational/Managerial Control Jan 1, 2016 100%

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Sharkey Issaquena Community HospitalRolling Fork, MS, CCN 258672 Rural health clinic 5% Or Greater Direct Ownership Interest Jan 1, 1966

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 2

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": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1922056050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 WEST RACE STREET",
            "city": "ROLLING FORK",
            "state": "MS",
            "postal_code": "39159",
            "telephone_number": "662-873-6218",
            "fax_number": "662-873-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 WEST RACE STREET",
            "city": "ROLLING FORK",
            "state": "MS",
            "postal_code": "39159",
            "telephone_number": "662-873-6218",
            "fax_number": "662-873-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHARKEY-ISSAQUENA COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "KEEVER",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "662-873-4395",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MS",
            "license": "539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "80489",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00230129",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sharkey Issaquena Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sharkey-Issaquena Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sharkey-Issaquena Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rolling Fork, MS

Sources for this page

Verify at the official NPI Registry.