INDEPENDENT HEALTHCARE MANAGEMENT, INC. (NPI# 1285956334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285956334 |
| Entity Type | Organization |
| Organization Name | INDEPENDENT HEALTHCARE MANAGEMENT, INC. |
| Other Organization Name | S.E. LACKEY MEMORIAL HOSPITAL |
| Practice Address |
330 N Broad St Forest MS 39074-3508 |
| Practice Telephone | 6014694151 |
| Practice Fax Number | 6014693681 |
| Mailing Telephone | 6014694151 |
| Mailing Fax Number | 6014693681 |
| Enumeration Date | 2010-02-17 |
| Last Update Date | 2020-05-26 |
| Authorized Official Name | JOHN P LEE (CHAIRMAN OF THE BOARD) |
| Authorized Official Telephone | 6018496440 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 367500000X | Nurse Anesthetist, Certified Registered | 13-033 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
13-033 | MS | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09013844 | 05 |
| Other Name | Type Code |
|---|---|
| S.E. Lackey Memorial Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427500958 | Independent Healthcare Management, Inc. | Family Medicine | 1123 Highway 35 S Ste 3, Forest, MS 39074-8829 | 2016-11-01 |
| 1396118378 | Independent Healthcare Management, Inc. | Clinic/Center | 9427 Eastside Drive Ext, Suite A, Newton, MS 39345-8063 | 2015-11-12 |
| 1154670719 | Independent Healthcare Management, Inc. | Clinic/Center | 1129 Highway 35 S, Suite 1, Forest, MS 39074-8829 | 2012-08-29 |
| 1760778609 | Independent Healthcare Management, Inc. | Clinic/Center | 17509 Hwy 21, Sebastopol, MS 39359-0000 | 2011-06-20 |
| 1952694994 | Independent Healthcare Management, Inc. | Clinic/Center | 347 S 4th St, Morton, MS 39117-3407 | 2011-05-24 |
| 1245489186 | Independent Healthcare Management, Inc. | Clinic/Center | 526 Deerfield Dr, Suite C, Forest, MS 39074-6005 | 2008-09-16 |
| 1306909734 | Independent Healthcare Management, Inc. | General Acute Care Hospital | 330 N Broad St, Forest, MS 39074-3508 | 2006-12-18 |
| 1255376729 | Independent Healthcare Management, Inc. | Clinic/Center | 330 N Broad St, Forest, MS 39074-3508 | 2006-06-18 |
| Street Address |
330 N BROAD ST |
| City | FOREST |
| State | MS |
| Zip Code | 39074-3508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891735692 | Independent Healthcare Management, Inc | General Acute Care Hospital | 330 N Broad St, Forest, MS 39074-3508 | 2006-06-08 |
| 1528672276 | Megan Elizabeth Mcdaniel | Nurse Practitioner | 330 N Broad St, Forest, MS 39074-3508 | 2020-09-01 |
| 1609323450 | Megan Otto | Nurse Practitioner | 330 N Broad St, Forest, MS 39074-3508 | 2016-09-08 |
| 1942555438 | Jenna C Benge | Nurse Practitioner | 330 N Broad St, Forest, MS 39074 | 2012-07-20 |
| 1417276106 | Nathan Lance Newman | Nurse Anesthetist, Certified Registered | 330 N Broad St, Forest, MS 39074-3508 | 2010-05-20 |
| 1649592791 | Independent Healthcare Management, Inc | General Acute Care Hospital | 330 N Broad St, Forest, MS 39074-3508 | 2010-02-17 |
| 1114170529 | Rori E. Bridges | Nurse Practitioner | 330 N Broad St, Forest, MS 39074-3508 | 2008-10-29 |
| 1114104734 | Heather Taylor | Nurse Practitioner | 330 N Broad St, Forest, MS 39074-3508 | 2008-01-25 |
| 1679799399 | Jimmie Nell Rawson | Nurse Anesthetist, Certified Registered | 330 N Broad St, Forest, MS 39074-3508 | 2007-04-18 |
| 1306909734 | Independent Healthcare Management, Inc. | General Acute Care Hospital | 330 N Broad St, Forest, MS 39074-3508 | 2006-12-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467095927 | Tamatha Nicole Owen | Nurse Practitioner | 1061 Highway 35 S, Forest, MS 39074 | 2019-10-28 |
| 1154687838 | Region Ten Commission On Mental Health | Clinic/Center | 13682 Hwy 80 West, Forest, MS 39074 | 2012-04-06 |
| 1053567636 | Cathy G Cooper | Physical Therapist | 813 West 3rd Street, Forest, MS 39074 | 2008-08-14 |
| 1487866158 | Terry Ann Meadows | Clinic/Center | 330 North Broad St, Forest, MS 39074 | 2007-05-04 |
| 1770702144 | Randy K Reynolds | Dentist | 208 West 3rd Street, Forest, MS 39074 | 2007-04-24 |
| 1215067293 | John B. Smith, Jr. Dmd, Pa | Dentist | 1040 Highway 35 South, Drawer 30, Forest, MS 39074 | 2007-03-07 |
| 1225189244 | Douglas F Harvel, Jr | Dentist | 1040 Highway 35 S, Forest, MS 39074 | 2007-01-16 |
| 1861542433 | Forest Dental Practice Pllc | Dentist | Po Drawer 30, Forest, MS 39074 | 2007-01-12 |
| 1306996970 | John B Smith Jr. | Dentist | 1040 Hwy 35 South, Forest, MS 39074 | 2007-01-12 |
| 1295821072 | Buddy Lee Eady | Chiropractor | 500 East 3rd St., Forest, MS 39074 | 2006-10-05 |
| Find all providers in zip 39074 | ||||
| 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 |
|---|---|---|---|---|
| 1891735692 | Independent Healthcare Management, Inc | General Acute Care Hospital | 330 N Broad St, Forest, MS 39074-3508 | 2006-06-08 |
| 1649592791 | Independent Healthcare Management, Inc | General Acute Care Hospital | 330 N Broad St, Forest, MS 39074-3508 | 2010-02-17 |
| 1306909734 | Independent Healthcare Management, Inc. | General Acute Care Hospital | 330 N Broad St, Forest, MS 39074-3508 | 2006-12-18 |
| 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 |
| 1063620110 | Prentiss Regional Hospital and Ecf, Inc. | General Acute Care Hospital | 1102 Rose St, Prentiss, MS 39474 | 2007-05-21 |
| 1316076524 | Prentiss Regional Hospital and Ecf, Inc. | General Acute Care Hospital | 1102 Rose St., Prentiss, MS 39474 | 2007-03-05 |
| 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 |
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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.