NPIMap

Organization Active NPI

Southwest Mississippi Regional Medical Center

Doing business as Monticello Family Practice

  • Primary Care Clinic/Center
  • Monticello, MS
National Provider Identifier
1992371579
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER
Doing business as
Monticello Family Practice
Practice address
827 F E Sellers Hwy
Monticello, MS 39654-9378
Phone
(601) 587-4648
Fax
(601) 587-0613
NPI assigned
Jun 3, 2021
Last updated
Mar 31, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Authorized official

Name
Charla Rowley
Title
Ceo
Phone
(601) 249-1806

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

827 F E Sellers Hwy
Monticello, MS 39654-9378

Mailing address

PO Box 490
McComb, MS 39649-0490
Phone (601) 250-4366

Other names 1

  • Monticello Family Practice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080512000089 MS Part B Supplier - Clinic/Group Practice 5193633907 Receives reassigned benefits from 13 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Monticello, MS

Other NPIs on the same Medicare enrollment 3

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

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
25D0320073Monticello Family Practice827 F E Sellers Hwy, Monticello, MS 39654Certificate of waiverJan 23, 2027

National Provider Directory

National Provider Directory
Tax ID family
SW Mississippi Reg Med Ctr35 organizations share this tax ID, including this one
Part of
SW Mississippi Reg Med Ctr

Other organizations with this tax ID 34

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

View all 34

Practitioners & affiliated clinicians

Practitioners 3

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": "1622678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774915200000",
    "number": "1992371579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396490490",
            "telephone_number": "601-250-4366",
            "fax_number": "601-250-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 F E SELLERS HWY",
            "city": "MONTICELLO",
            "state": "MS",
            "postal_code": "396549378",
            "telephone_number": "601-587-4648",
            "fax_number": "601-587-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER",
        "enumeration_date": "2021-06-03",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A",
        "authorized_official_last_name": "ROWLEY",
        "authorized_official_first_name": "CHARLA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-249-1806"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monticello Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monticello, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.