EAST MISSISSIPPI STATE HOSPITAL (NPI# 1407269756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407269756 |
| Entity Type | Organization |
| Organization Name | EAST MISSISSIPPI STATE HOSPITAL |
| Practice Address |
1401 College Dr Meridian MS 39307-5345 |
| Mailing Address |
Po Box 4128 Meridian MS 39304-4128 |
| Practice Telephone | 6015877562 |
| Practice Fax Number | 6015817707 |
| Mailing Telephone | 6015817562 |
| Mailing Fax Number | 6015817707 |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2020-05-05 |
| Authorized Official Name | MR. WILLIAM HAMRICK ENTREKIN (BUSINESS SERVICES DIRECTOR) |
| Authorized Official Telephone | 6015817969 |
| Is Organization Subpart | Y |
| Parent Organization Name | BRADLEY A. SANDERS ADOLESCENT COMPLEX |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | 31-136 | MS | Hospital Units |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972689313 | East Mississippi State Hospital | Nursing Facility/Intermediate Care Facility | 4555 Highland Park Drive, Meridian, MS 39307-2903 | 2006-10-27 |
| 1346522653 | East Mississippi State Hospital | Clinic/Center | 1818 College Drive, Meridian, MS 39307-5429 | 2011-09-13 |
| 1225342173 | East Mississippi State Hospital | Psychiatric Hospital | 4555 Highland Park Drive, Meridian, MS 39307 | 2010-08-03 |
| 1629394853 | East Mississippi State Hospital | Nursing Facility/Intermediate Care Facility | 4555 Highland Park Dr, Meridian, MS 39307-5429 | 2010-04-13 |
| 1841490612 | East Mississippi State Hospital | Dentist | 1818 College Drive, Reimbursement Dept., Meridian, MS 39307-5429 | 2007-07-20 |
| 1649323254 | East Mississippi State Hospital | Psychiatric Hospital | 4555 Highland Park Dr, Meridian, MS 39307 | 2007-01-18 |
| Street Address |
1401 COLLEGE DR |
| City | MERIDIAN |
| State | MS |
| Zip Code | 39307-5345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841824232 | Erica Sheree Smith | Registered Nurse | 1818 College Dr, Meridian, MS 39307 | 2020-02-25 |
| 1518481480 | Derrick Pringle | Social Worker | 110 48th Ave, Meridian, MS 39307 | 2017-08-01 |
| 1821519547 | Leslie Rutkowski | Student in an Organized Health Care Education/Training Program | 2514 67th Avenue Loop Suite 112, Meridian, MS 39307 | 2017-07-03 |
| 1811254931 | Meridian Community College | Dentist | 910 Highway 19 North, Meridian, MS 39307 | 2012-04-13 |
| 1548533672 | Carvan Lorraine Carter | Counselor | 1807 39th Pl, Meridian, MS 39307 | 2012-02-21 |
| 1699921148 | Sara B Smith | Counselor | 1415 College Drive, Meridian, MS 39307 | 2008-08-15 |
| 1285856112 | Jan Parr Boggs | Psychologist | 1508 37th Avenue, Meridian, MS 39307 | 2007-05-02 |
| 1720694029 | Michelle Gomez Dickerson | Registered Nurse | 1818 College Drive, Meridian, MS 39307 | 2020-09-22 |
| 1770116030 | Briana Shanee Brunson | Nurse Practitioner | 1818 College Drive, Meridian, MS 39307 | 2020-02-14 |
| 1619507407 | Brenda A Thompson | Nurse Practitioner | 1818 College Drive, Meridian, MS 39307 | 2020-01-21 |
| Find all providers in zip 39307 | ||||
| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831184951 | Alliance Health Center Inc | Psychiatric Unit | 5000 Highway 39 N, Meridian, MS 39301-1021 | 2005-09-14 |
| 1497016117 | Anderson Regional Medical Center | Psychiatric Unit | 1102 Constitution Ave, Meridian, MS 39301-4001 | 2012-05-30 |
| 1811156326 | Alliance Health Center, Inc. | Psychiatric Unit | 5000 Hwy 39 N, Meridian, MS 39301-1021 | 2008-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699803395 | Walter Robert Jones Jr. | Psychiatric Unit | Hwy 468, Hudspeth Regional Center, Whitfield, MS 39193 | 2007-03-02 |
| 1740228881 | Vicksburg Healthcare LLC | Psychiatric Unit | 1111 N Frontage Rd, Vicksburg, MS 39180-5102 | 2006-06-02 |
| 1306803481 | George County Hospital | Psychiatric Unit | 859 Winter Steet, Lucedale, MS 39452-6603 | 2006-05-01 |
| 1457330995 | South Mississippi State Hospital | Psychiatric Unit | 823 Highway 589, Purvis, MS 39475-4194 | 2006-01-12 |
| 1801414115 | Singing River Gulfport | Psychiatric Unit | 15200 Community Rd, Gulfport, MS 39503-3085 | 2020-07-13 |
| 1679036313 | Progressive Medical Management of Batesville LLC | Psychiatric Unit | 155 Keating Rd, Batesville, MS 38606-2901 | 2019-04-10 |
| 1689191629 | Boa Vida Hospital of Aberdeen, Ms, LLC | Psychiatric Unit | 400 S Chestnut St, Aberdeen, MS 39730-3335 | 2017-08-29 |
| 1033643937 | Batesville Regional Medical Center, Inc. | Psychiatric Unit | 303 Medical Center Dr, Batesville, MS 38606-8608 | 2017-04-18 |
| 1801329834 | Lifebrite Hospital Group of Aberdeen LLC | Psychiatric Unit | 400 S Chestnut St, Aberdeen, MS 39730-3335 | 2017-04-06 |
| 1518414416 | Freedom Hospital of Magnolia LLC | Psychiatric Unit | 205 N Cherry St, Magnolia, MS 39652-2819 | 2016-09-08 |
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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.