PRENTISS REGIONAL HOSPITAL AND ECF, INC. (NPI# 1063620110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063620110 |
| Entity Type | Organization |
| Organization Name | PRENTISS REGIONAL HOSPITAL AND ECF, INC. |
| Other Organization Name | JEFFERSON DAVIS COMMUNITY HOSPITAL |
| Practice Address |
1102 Rose St Prentiss MS 39474 |
| Mailing Address |
Po Box 1288 Prentiss MS 39474-1288 |
| Practice Telephone | 6017924276 |
| Practice Fax Number | 6017922947 |
| Mailing Telephone | 6017924276 |
| Mailing Fax Number | 6017922947 |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. GARY LEE MCCALL JR. (COO) |
| Authorized Official Telephone | 6017924276 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
16-179 | MS | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09014591 | 05 |
| Other Name | Type Code |
|---|---|
| Jefferson Davis Community Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316076524 | Prentiss Regional Hospital and Ecf, Inc. | General Acute Care Hospital | 1102 Rose St., Prentiss, MS 39474 | 2007-03-05 |
| 1225167430 | Prentiss Regional Hospital and Ecf, Inc. | Skilled Nursing Facility | 1320 Winfield St., Prentiss, MS 39474 | 2007-03-05 |
| 1417146259 | Prentiss Regional Hospital and Ecf, Inc. | Clinic/Center | 4297 Highway 42, Bassfield, MS 39421 | 2007-10-17 |
| 1629107990 | Prentiss Regional Hospital and Ecf, Inc. | Psychiatric Unit | 1102 Rose Street, Prentiss, MS 39474 | 2007-03-05 |
| Street Address |
1102 ROSE ST |
| City | PRENTISS |
| State | MS |
| Zip Code | 39474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336769306 | Keely Fortenberry | Occupational Therapist | 1102 Rose St, Prentiss, MS 39474-5200 | 2020-04-20 |
| 1730452558 | Forrest County General Hospital | Anesthesiology | 1102 Rose St, Prentiss, MS 39474-5200 | 2012-02-10 |
| 1649558388 | Forrest County General Hospital | Medicare Defined Swing Bed Unit | 1102 Rose St, Prentiss, MS 39474-5200 | 2011-07-29 |
| 1003194747 | Forrest County General Hospital | Psychiatric Unit | 1102 Rose St, Prentiss, MS 39474-5200 | 2011-07-29 |
| 1518245307 | Forrest County General Hospital | Skilled Nursing Facility | 1102 Rose St, Prentiss, MS 39474-5200 | 2011-07-27 |
| 1295013316 | Forrest County General Hospital | General Acute Care Hospital | 1102 Rose St, Prentiss, MS 39474-5200 | 2011-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225520794 | Caring Hands Staffing,llc | In Home Supportive Care | 1802 Columbia Ave, Prentiss, MS 39474 | 2018-05-31 |
| 1891183208 | Katie Daley Rush | Nurse Practitioner | 1014 Rose St., Ste. A, Prentiss, MS 39474 | 2015-01-07 |
| 1841621885 | Living Hope; LLC | Assisted Living Facility | 1287 Fred Street, Prentiss, MS 39474 | 2013-12-02 |
| 1922317197 | Martha Ann Stringer | Pharmacist | 1635 Columbia Ave., Prentiss, MS 39474 | 2010-10-05 |
| 1427361666 | Caring Hands Personal Care LLC | Home Health | 1814 Columbia Ave. Ste. B, Prentiss, MS 39474 | 2010-07-16 |
| 1730308206 | James Russell Dumas Jr. | Dentist | 7115 Hwy 13, Prentiss, MS 39474 | 2007-04-24 |
| 1316076524 | Prentiss Regional Hospital and Ecf, Inc. | General Acute Care Hospital | 1102 Rose St., Prentiss, MS 39474 | 2007-03-05 |
| 1225167430 | Prentiss Regional Hospital and Ecf, Inc. | Skilled Nursing Facility | 1320 Winfield St., Prentiss, MS 39474 | 2007-03-05 |
| 1033292727 | Vonpatton's, LLC | Durable Medical Equipment & Medical Supplies | 2218 Columbia Ave, Prentiss, MS 39474 | 2006-10-24 |
| 1326149253 | Jaishankar Jagadeesan | Internal Medicine | 972 Columbia Ave, Prentiss, MS 39474 | 2006-09-25 |
| Find all providers in zip 39474 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316076524 | Prentiss Regional Hospital and Ecf, Inc. | General Acute Care Hospital | 1102 Rose St., Prentiss, MS 39474 | 2007-03-05 |
| 1467495127 | Prentiss Regional Hospital and Extended Care Facility, Inc. | General Acute Care Hospital | 1102 Rose Street, Prentiss, MS 39474-1288 | 2006-06-13 |
| 1295013316 | Forrest County General Hospital | General Acute Care Hospital | 1102 Rose St, Prentiss, MS 39474-5200 | 2011-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730566027 | Bmc - Attala, LLC | General Acute Care Hospital | 220 Hwy. 12 West, Kosciusko, MS 39090 | 2015-05-06 |
| 1700284502 | Cody Allen Simpson | General Acute Care Hospital | 401 Southcrest Cir Ste 203, Southaven, MS 38671-6719 | 2014-12-10 |
| 1326453648 | Kings Daughters Hospital of Yazoo County, Inc | General Acute Care Hospital | 748 E 15 St., Yazoo City, MS 39194 | 2014-06-25 |
| 1003026717 | Forrest County General Hospital | General Acute Care Hospital | 305 W Moody St, Poplarville, MS 39470 | 2007-05-23 |
| 1144339839 | Simpson Community Healthcare, Inc. | General Acute Care Hospital | 1842 Simpson Highway 149, Mendenhall, MS 39114-3438 | 2006-08-29 |
| 1821103516 | Pontotoc Health Services, Inc. | General Acute Care Hospital | 176 S Main St, Pontotoc, MS 38863-3311 | 2006-08-20 |
| 1386654309 | Stone County Hospital, Inc. | General Acute Care Hospital | 1434 Central Ave E, P O Drawer 97, Wiggins, MS 39577-9602 | 2006-08-09 |
| 1477563427 | State of Mississippi - University of Mississippi Medical Center | General Acute Care Hospital | 239 Bowling Green Road, Lexington, MS 39095 | 2006-08-09 |
| 1114951324 | Patients Choice Medical Center of Humphreys County, LLC | General Acute Care Hospital | 500 C C Rd, Belzoni, MS 39038-3806 | 2006-07-11 |
| 1932143989 | Perry County General Hospital | General Acute Care Hospital | 206 Bay Street, Richton, MS 39476-1665 | 2006-06-16 |
| Find all providers with the same taxonomy | ||||
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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.