Southwest Mississippi Regional Medical Center
Organization Active NPI Primary Care Clinic/Center · Monticello, MS
NPI 1992371579 · NPPES record last updated Mar 31, 2026
Key facts
- NPI
- 1992371579
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER
- Practice address
- 827 F E Sellers Hwy
Monticello, MS 39654-9378 - Phone
- (601) 587-4648
- Fax
- (601) 587-0613
- NPI assigned
- Jun 3, 2021
- Organization subpart
- Yes
- Parent organization (as reported)
- SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER
Authorized official
- Name
- Charla Rowley
- Title
- Ceo
- Phone
- (601) 249-1806
Other NPIs on the same Medicare enrollment 3
Corporate family (same tax ID) 32
Practitioners 3
-
Rhonda Joyce Thomas, FNP-C, ACNP
-
Tyler Thompson, NP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 25D0320073 | Monticello Family Practice | Certificate of waiver | Jan 23, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Smrmcgastroenterology
- Part of
- Smrmcgastroenterology
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Yes |
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
- Monticello Family Practice
Other providers in Monticello, MS
- Southwest Mississippi Regional Medical Center
- Southwest Mississippi Regional Medical Center
- Southwest Mississippi Regional Medical Center
- Southwest Mississippi Regional Medical Center
- Southwest Mississippi Regional Medical Center
- Southwest Mississippi Regional Medical Center
- Southwest Ms Regional Medical Center
- St. Luke Home Health Services, LLC
- James Wyatt Stephens
- Deontranese Treva Taylor
All providers in Monticello, MS · Primary Care Clinic/Center in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2026. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.