KPC PROMISE HOSPITAL OF VICKSBURG LLC (NPI# 1124682570) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124682570 |
| Entity Type | Organization |
| Organization Name | KPC PROMISE HOSPITAL OF VICKSBURG LLC |
| Practice Address |
2100 Highway 61 N Vicksburg MS 39183-8211 |
| Mailing Address |
9 Kpc Pkwy Ste 301 Corona CA 92879-7102 |
| Practice Telephone | 6018833265 |
| Mailing Telephone | 9519878100 |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2019-04-30 |
| Authorized Official Name | WILLIAM THOMAS (SECRETARY) |
| Authorized Official Telephone | 9519878100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282E00000X | Long Term Care Hospital | Hospitals |
| Street Address |
2100 HIGHWAY 61 N |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39183-8211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457357691 | Tulio Figarola | Orthopaedic Surgery | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2005-06-22 |
| 1639799430 | Vicksburg Healthcare LLC | Clinical Medical Laboratory | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2020-04-21 |
| 1407481880 | Casey Elaine Collier | Physician Assistant | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2020-03-06 |
| 1144789801 | Laura Lavee Burris | Physician Assistant | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2019-03-12 |
| 1134699192 | Lisa Wamsley | Pharmacist | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2018-12-03 |
| 1619456621 | Kimberly Washington | Physical Therapist | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2018-08-09 |
| 1114459070 | Thulasi Ram Gudi | Internal Medicine | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2017-03-30 |
| 1518403617 | Brett Myers Scruggs | Nurse Anesthetist, Certified Registered | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2017-01-12 |
| 1770933731 | Cesar Luis Merino | Hospitalist | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2016-06-20 |
| 1073960647 | Andrew Hendrix | Registered Nurse | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2016-05-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306217823 | Tracy Curtis | Speech-Language Pathologist | 2100 Us 61, Vicksburg, MS 39183 | 2015-10-09 |
| 1649566894 | The Life Balance Clinic, Behavioral Health Service | Social Worker | 1107 B Openwood St., Vicksburg, MS 39183 | 2011-06-27 |
| 1245428788 | Melanie Joan Waldrop | Nurse Anesthetist, Certified Registered | 2100 Hwy 61n, River Region Medical Center, Vicksburg, MS 39183 | 2007-10-10 |
| 1871714477 | Robert Michael Coleman | Dentist | 2356 Grove Street, Vicksburg, MS 39183 | 2007-05-01 |
| 1942363502 | Visions Physical Therapy | Physical Therapist | 110 Holt Collier Dr, Vicksburg, MS 39183 | 2006-12-18 |
| 1023117991 | Janet S Fisher Dmd Pa | Dentist | 1212 Mission 66, Vicksburg, MS 39183 | 2006-09-21 |
| 1407878663 | Annette Bryant | Social Worker | 1107 Openwood St, Vicksburg, MS 39183 | 2006-07-24 |
| 1932168416 | Promise Hospital of Vicksburg Inc | Long Term Care Hospital | 2100 Highway 61 N Fl 6, Vicksburg, MS 39183 | 2006-03-22 |
| 1164945374 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2310 Clay St, Vicksburg, MS 39183 | 2017-07-19 |
| 1811244858 | Life Balance Clinic LLC | Social Worker | 1107 Openwood St, Vicksburg, MS 39183 | 2012-08-09 |
| Find all providers in zip 39183 | ||||
| Taxonomy Code | 282E00000X |
| Grouping | Hospitals |
| Classification | Long Term Care Hospital |
| Long-term care hospitals (LTCHs) furnish extended medical and rehabilitative care to individuals who are clinically complex and have multiple acute or chronic conditions. |
| Notes: Source: American Hospital Association [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932168416 | Promise Hospital of Vicksburg Inc | Long Term Care Hospital | 2100 Highway 61 N Fl 6, Vicksburg, MS 39183 | 2006-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730240011 | Regency Hospital of Southern Mississippi LLC | Long Term Care Hospital | 220 27th Avenue, Hattiesburg, MS 39401-7165 | 2006-12-12 |
| 1982606570 | Regency Hospital of Hattiesburg, LLC | Long Term Care Hospital | 125 S 25th Ave, Hattiesburg, MS 39401-6031 | 2005-08-12 |
| 1952303778 | Regency Hospital Company of Meridian, LLC | Long Term Care Hospital | 1102 Constitution Ave, 2nd Floor, Meridian, MS 39301-4001 | 2005-08-11 |
| 1518967280 | Select Specialty Hospital - Gulf Coast Inc | Long Term Care Hospital | 1520 Broad Ave, Gulfport, MS 39501-3601 | 2005-07-26 |
| 1255330163 | Select Specialty Hospital - Jackson Inc | Long Term Care Hospital | 5903 Ridgewood Rd, Jackson, MS 39211-3700 | 2005-07-21 |
| 1619326014 | Select Specialty Hospital - Belhaven, LLC | Long Term Care Hospital | 1225 N State St, Jackson, MS 39202-2064 | 2016-06-07 |
| 1255661203 | Select Employment Services, Inc | Long Term Care Hospital | 1520 Broad Ave, Gulfport, MS 39501-3601 | 2010-01-13 |
| 1619109535 | Ltac Hospital of Greenwood, LLC | Long Term Care Hospital | 1401 River Rd, 2nd Floor, Greenwood, MS 38930-4030 | 2009-08-11 |
| 1154560290 | Allegiance Specialty Hospital of Greenville, LLC | Long Term Care Hospital | 300 Washington Ave, Greenville, MS 38701-3614 | 2009-02-12 |
| 1275700064 | Forrest County General Hospital | Long Term Care Hospital | 130 Highland Pkwy, Picayune, MS 39466-5574 | 2008-05-12 |
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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.