STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER (NPI# 1003431602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003431602 |
| Entity Type | Organization |
| Organization Name | STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER |
| Practice Address |
960 Avent Dr Grenada MS 38901-5230 |
| Practice Telephone | 6622277000 |
| Mailing Telephone | 6622277000 |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-06-10 |
| Authorized Official Name | MR. SCOTT WHITTEMORE (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 6622277172 |
| Is Organization Subpart | Y |
| Parent Organization Name | STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 275N00000X | Medicare Defined Swing Bed Unit | Hospital Units |
| Other Name | Type Code |
|---|---|
| University of Mississippi Medical Center- Grenada Swing Bed | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013563527 | State of Mississippi - University of Mississippi Medical Center | Prosthetic/Orthotic Supplier | 1410 E Woodrow Wilson Ave Ste I, Jackson, MS 39216-5114 | 2019-08-12 |
| 1194738393 | State of Mississippi - University of Mississippi Medical Center | Clinic/Center | 18295 Emory Road, West, MS 39192-0000 | 2006-08-15 |
| 1477563427 | State of Mississippi - University of Mississippi Medical Center | General Acute Care Hospital | 239 Bowling Green Road, Lexington, MS 39095 | 2006-08-09 |
| 1700872173 | State of Mississippi - University of Mississippi Medical Center | Medicare Defined Swing Bed Unit | 239 Bowling Green Rd, Lexington, MS 39095-5167 | 2005-09-21 |
| 1821525957 | State of Mississippi - University of Mississippi Medical Center | Clinic/Center | 1300 Sunset Dr Ste F, Grenada, MS 38901-4083 | 2017-05-19 |
| 1528595667 | State of Mississippi - University of Mississippi Medical Center | Clinic/Center | 418b N Applegate St, Winona, MS 38967-1827 | 2017-05-19 |
| 1255883690 | State of Mississippi - University of Mississippi Medical Center | Clinic/Center | 2500 N State St, Jmm Suite 2525, Jackson, MS 39216-4500 | 2016-11-02 |
| 1376969030 | State of Mississippi - University of Mississippi Medical Center | Clinic/Center | 2500 N State St, Jackson, MS 39216-4500 | 2014-03-05 |
| 1972759132 | State of Mississippi - University of Mississippi Medical Center | Nurse Anesthetist, Certified Registered | 2500 N State St, Jackson, MS 39216-4500 | 2008-08-07 |
| 1972759140 | State of Mississippi - University of Mississippi Medical Center | Dietitian, Registered | 2500 N State St, Jackson, MS 39216-4500 | 2008-08-07 |
| Street Address |
960 AVENT DR |
| City | GRENADA |
| State | MS |
| Zip Code | 38901-5230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386644789 | Grenada Lake Medical Center | General Acute Care Hospital | 960 Avent Dr, Grenada, MS 38901-5230 | 2005-07-28 |
| 1356961320 | Angelina Guilambo | Physical Therapist | 960 Avent Dr, Grenada, MS 38901-5230 | 2020-04-20 |
| 1841822152 | Shelby Helen Phelon Jackson | Nurse Practitioner | 960 Avent Dr, Grenada, MS 38901-5230 | 2020-02-05 |
| 1194388082 | Grenada Emergency Group, LLC | Physician Assistant | 960 Avent Dr, Grenada, MS 38901-5230 | 2019-04-17 |
| 1932762721 | Grenada Physician Services, LLC | Nurse Practitioner | 960 Avent Dr, Grenada, MS 38901-5230 | 2019-04-17 |
| 1013489319 | Kelsey Marter Moncrief | Nurse Practitioner | 960 Avent Dr, Grenada, MS 38901-5230 | 2018-12-26 |
| 1760908321 | Linda Gail Carter | Nurse Practitioner | 960 Avent Dr, Grenada, MS 38901-5230 | 2017-08-16 |
| 1528463486 | Marionette Yarbrough | Physical Therapist | 960 Avent Dr, Grenada, MS 38901-5230 | 2014-11-04 |
| 1720419583 | State of Mississippi-university of Mississippi Medical Center | General Acute Care Hospital | 960 Avent Dr, Grenada, MS 38901-5230 | 2013-12-04 |
| 1639500499 | State of Mississippi-university of Mississippi Medical Center | Durable Medical Equipment & Medical Supplies | 960 Avent Dr, Grenada, MS 38901-5230 | 2013-12-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902435118 | The Mane Physician | Prosthetic/Orthotic Supplier | 94 Spain Drive, Grenada, MS 38901 | 2020-04-08 |
| 1942842166 | Sylvia C Bass | Technician | 813 Union Street, Grenada, MS 38901 | 2019-10-09 |
| 1669971180 | Jenny Taylor | Nurse Practitioner | 350 Sunset Drive, Grenada, MS 38901 | 2018-02-10 |
| 1073912762 | John Thomas Mcree I | Counselor | 2026 Commerce St Ste 8e, Grenada, MS 38901 | 2014-08-19 |
| 1700213634 | State of Mississippi-university of Mississippi Medical Center | Home Health | 960 Avent Drive, Grenada, MS 38901 | 2013-10-10 |
| 1114359866 | Cmhp Enterprises | Dentist | 1420 Wooded Drive, Grenada, MS 38901 | 2013-08-05 |
| 1518256460 | Mercy Hospice LLC | Hospice Care, Community Based | 1410 Wooded Drive, Grenada, MS 38901 | 2011-03-31 |
| 1215256318 | Della Lea Welsh | Speech-Language Pathologist | 1321 Dd Sunset Dr., Grenada, MS 38901 | 2010-05-28 |
| 1750514543 | Family Health Care Clinic, Inc. | Clinic/Center | 1102 Telegraph St, Grenada, MS 38901 | 2009-08-27 |
| 1033384771 | Jason K Bennett | Pharmacist | 140 Shadow Wood Cv, Grenada, MS 38901 | 2008-04-24 |
| Find all providers in zip 38901 | ||||
| Taxonomy Code | 275N00000X |
| Grouping | Hospital Units |
| Classification | Medicare Defined Swing Bed Unit |
| A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |
| Notes: Source: Code of Federal Regulations #42, Section 482.66. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568626216 | Guardian Angel Healthcare Inc., II | Medicare Defined Swing Bed Unit | 347 Magnolia Drive, Raleigh, MS 39153 | 2008-07-11 |
| 1487863692 | Kilmichael Hospital | Medicare Defined Swing Bed Unit | 301 Lamar Ave, Kilmichael, MS 39747 | 2007-05-22 |
| 1972620292 | Yalobusha General Hospital | Medicare Defined Swing Bed Unit | 630 South Main Street, Water Valley, MS 38965-3468 | 2007-03-23 |
| 1659404770 | Patients Choice Medical Center of Humphreys County, LLC | Medicare Defined Swing Bed Unit | 500 C C C Rd, Belzoni, MS 39038-3806 | 2007-03-14 |
| 1104904457 | Claiborne County Hospital | Medicare Defined Swing Bed Unit | 123 Mccomb Avenue, Port Gibson, MS 39150-1004 | 2006-11-02 |
| 1972538270 | Tippah County Hospital | Medicare Defined Swing Bed Unit | 1005 City Avenue North, Ripley, MS 38663-0499 | 2006-07-12 |
| 1700872173 | State of Mississippi - University of Mississippi Medical Center | Medicare Defined Swing Bed Unit | 239 Bowling Green Rd, Lexington, MS 39095-5167 | 2005-09-21 |
| 1447253521 | Pioneer Health Services of Newton County, LLC | Medicare Defined Swing Bed Unit | 9421 Eastside Drive Extention, Newton, MS 39345-2613 | 2005-05-23 |
| 1457979908 | Natchez Hospital Company LLC | Medicare Defined Swing Bed Unit | 54 Sergeant Prentiss Dr, Natchez, MS 39120-4726 | 2020-07-10 |
| 1740833391 | Guardian Angel Healthcare II, Inc. | Medicare Defined Swing Bed Unit | 347 Magnolia Dr, Raleigh, MS 39153-6011 | 2019-07-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.