South Sunflower County Hospital
Organization Active NPI Advanced Practice Midwife · Indianola, MS
NPI 1962395863 · NPPES record last updated May 30, 2025
Key facts
- NPI
- 1962395863
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Advanced Practice Midwife 367A00000X
- Legal business name
- SOUTH SUNFLOWER COUNTY HOSPITAL
- Practice address
- 121 E Baker St
Indianola, MS 38751-2498 - Phone
- (662) 635-7210
- NPI assigned
- May 30, 2025
- Organization subpart
- No
Authorized official
- Name
- Courtney Phillips
- Title
- Ceo
- Phone
- (662) 635-7200
Other NPIs on the same Medicare enrollment 8
Corporate family (same tax ID) 13
Practitioners 85
-
David M Bartley, CRNA
-
Christopher Lyell Behr, M.D.
-
Roger Alan Blake, M.D.
-
Gina Vick Bray, DO
-
Stuart Britt, CRNA
-
Mack Allen Brown, CRNA
-
Robert L Brunston Jr., M.D.
-
Lindsay Burke, FNP-C
-
James Gregory Burnham, CRNA
-
Andrea Jemae Collins, M.D.
-
Felton Combest, MD
-
Brandon J Craft, NP
-
Elizabeth Baird Dawson, CFNP
-
Edgar N Donahoe Jr., M.D.
-
Terry Dorsey, NP
-
William Wade Dowell, M.D.
-
Laura Elizabeth Turner Downs, FNP-C
-
Derrick R. Duffield, M. D.
-
Cedric Edwards, M.D.
-
Joshua E Fuqua, CRNA
-
Robert A. Gannaway, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040218000979 | MS | Part B Supplier - Clinic/Group Practice | 6709771637 |
Receives reassigned benefits from 88 practitioners 8 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Indianola, MS |
National Provider Directory
- Tax ID family
- South Sunflower County
Locations
108 Clarington Dr
Southaven, MS 38671
Phone (662) 349-9043
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife |
367A00000X | Yes |
Addresses
Primary practice location
121 E Baker St
Indianola, MS 38751-2498
Mailing address
121 E Baker St
Indianola, MS 38751-2498
Phone (662) 635-7210
Other providers in Indianola, MS
- South Sunflower County Hospital
- South Sunflower County Hospital
- South Sunflower County Hospital
- South Sunflower County Hospital
- South Sunflower County Hospital
- South Sunflower County Hospital
- St John'S Adult Day Services, LLC
- St John'S Personal Care Services LLC
- St. John'S Personal Care Services, LLC
- St. John'S Respite Care Services, LLC
All providers in Indianola, MS · Advanced Practice Midwife in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 30, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.