CHOCTAW REGIONAL MEDICAL CENTER (NPI# 1538555347) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538555347 |
| Entity Type | Organization |
| Organization Name | CHOCTAW REGIONAL MEDICAL CENTER |
| Other Organization Name | LOUISVILLE MEDICAL CLINIC |
| Practice Address |
14724 Highway 15 N Louisville MS 39339-6318 |
| Mailing Address |
8613 Ms Highway 12 Ackerman MS 39735-8917 |
| Practice Telephone | 6627737500 |
| Mailing Telephone | 6622859460 |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2020-03-10 |
| Authorized Official Name | JAMIE RODGERS (ADMINISTRATOR) |
| Authorized Official Telephone | 6622854400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 01771892 | 05 |
| Other Name | Type Code |
|---|---|
| Louisville Medical Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225446578 | Choctaw Regional Medical Center | Personal Emergency Response Attendant | 8613 Ms Highway 12, Ackerman, MS 39735-8917 | 2014-07-31 |
| 1609284959 | Choctaw Regional Medical Center | Medicare Defined Swing Bed Unit | 8613 Ms Highway 12, Ackerman, MS 39735-8917 | 2014-07-31 |
| 1235547878 | Choctaw Regional Medical Center | Clinic/Center | 64 N Louisville St, Ackerman, MS 39735-9217 | 2014-07-28 |
| 1174931844 | Choctaw Regional Medical Center | Clinic/Center | 780 Main St, Weir, MS 39772-9058 | 2014-07-25 |
| 1285041582 | Choctaw Regional Medical Center | Medicare Defined Swing Bed Unit | 8613 Ms Highway 12, Ackerman, MS 39735-8917 | 2014-07-18 |
| 1003223306 | Choctaw Regional Medical Center | Clinic/Center | 8613 Ms Highway 12, Ackerman, MS 39735-8917 | 2014-07-18 |
| 1568879864 | Choctaw Regional Medical Center | Personal Emergency Response Attendant | 8613 Ms Highway 12, Ackerman, MS 39735-8917 | 2014-07-18 |
| 1518374875 | Choctaw Regional Medical Center | Skilled Nursing Facility | 311 W Cherry St, Ackerman, MS 39735-8708 | 2014-07-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CHOCTAW REGIONAL MEDICAL CENTER | 8613 Ms Highway 12, Ackerman, MS 39735-8917 |
| Street Address |
14724 HIGHWAY 15 N |
| City | LOUISVILLE |
| State | MS |
| Zip Code | 39339-6318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114912680 | James Glenn Peters | Family Medicine | 14724 Highway 15 N, Louisville, MS 39339-6318 | 2005-09-12 |
| 1851905137 | Shelby Reeves | Nurse Practitioner | 14724 Highway 15 N, Louisville, MS 39339-6318 | 2020-09-03 |
| 1972085850 | Brianna Deweese Lundy | Nurse Practitioner | 14724 Highway 15 N, Louisville, MS 39339-6318 | 2018-09-06 |
| 1598263709 | Casey Devaughn Fleming | Nurse Practitioner | 14724 Highway 15 N, Louisville, MS 39339-6318 | 2018-01-23 |
| 1205355765 | Jessica Clark Mills | Nurse Practitioner | 14724 Highway 15 N, Louisville, MS 39339-6318 | 2017-09-15 |
| 1851781611 | Pamela Metts | Nurse Practitioner | 14724 Highway 15 N, Louisville, MS 39339-6318 | 2015-02-02 |
| 1346337920 | Cynthia Harrington | Nurse Practitioner | 14724 Highway 15 N, Louisville, MS 39339-6318 | 2006-10-06 |
| 1184675134 | Jan Sullivan Randle | Nurse Practitioner | 14724 Highway 15 N, Louisville, MS 39339-6318 | 2006-05-15 |
| 1598716573 | Valerie O'briant Sullivan | Nurse Practitioner | 14724 Highway 15 N, Louisville, MS 39339-6318 | 2006-05-13 |
| 1497705453 | Samuel Keith Suttle | Family Medicine | 14724 Highway 15 N, Louisville, MS 39339-6318 | 2006-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972149573 | Thomas Cefalu | Pharmacist | 16575 E Main St, Louisville, MS 39339 | 2019-11-19 |
| 1720506371 | Jennifer Marie Burns | Physical Therapist | 110 N Walmart Drive Suite F, Louisville, MS 39339 | 2017-09-05 |
| 1326409335 | Courtney Nicole Shaw | Speech-Language Pathologist | 316 Rocky Hill Road, Louisville, MS 39339 | 2016-03-18 |
| 1033598503 | Winston Medical Clinic LLC | Clinic/Center | 16569 W Main St, Louisville, MS 39339 | 2015-05-29 |
| 1689969735 | Adam C Byrd | Dermatology | 313 N Court Ave, Ummc Dermatology - Louisville Clinic, Louisville, MS 39339 | 2011-06-16 |
| 1356587208 | Louisville Healthcare LLC | Skilled Nursing Facility | 543 East Main Street, Louisville, MS 39339 | 2008-12-24 |
| 1699935908 | Stephen Eugene Hunter | Emergency Medicine | 100 Ellie Smith Rd, Louisville, MS 39339 | 2008-06-10 |
| 1669566279 | Southern Pharmaceutical Corporation | Durable Medical Equipment & Medical Supplies | 17220 E Main St Ste C, Louisville, MS 39339 | 2006-10-03 |
| 1184737017 | Louisville Eye Care | Optometrist | 500 North Church, Louisville, MS 39339 | 2006-08-16 |
| 1679583249 | Raymond John Orgler | Surgery | 547 E. Main St, Louisville, MS 39339 | 2006-08-08 |
| Find all providers in zip 39339 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033598503 | Winston Medical Clinic LLC | Clinic/Center | 16569 W Main St, Louisville, MS 39339 | 2015-05-29 |
| 1437290798 | Family Health Clinic | Clinic/Center | 134 S. Church St., Louisville, IL 62858 | 2007-02-09 |
| 1538190624 | Attentus Eufaula, LLC | Clinic/Center | 31 Railroad St, Louisville, AL 36048-3134 | 2006-07-06 |
| 1134750243 | Trinity Health and Wellness, LLC. | Clinic/Center | 850 Bryant St, Louisville, IL 62858-1000 | 2020-01-28 |
| 1134632045 | The Health Care Authority of The City of Eufaula | Clinic/Center | 31 Railroad St, Louisville, AL 36048-3123 | 2017-11-14 |
| 1063878106 | Medical-care LLC | Clinic/Center | 809 Peachtree St, Louisville, GA 30434-1449 | 2016-01-05 |
| 1629417324 | Winston Medical Clinic LLC | Clinic/Center | 923 S Church Ave, Louisville, MS 39339 | 2013-06-17 |
| 1215943915 | Hospital Authority of Jefferson County and The City of Louisville | Clinic/Center | 1067 Peachtree St, Louisville, GA 30434-1558 | 2006-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730786120 | Ochsner Medical Center - Hancock, LLC | Clinic/Center | 2274 Highway 43 S Ste 200, Picayune, MS 39466-8141 | 2020-10-08 |
| 1306460282 | Covington County Hospital | Clinic/Center | 105 Eaton St, Taylorsville, MS 39168-5614 | 2020-06-05 |
| 1871117747 | Covington County Hospital | Clinic/Center | 1039 Highway 42 Ste C, Sumrall, MS 39482-4478 | 2020-06-05 |
| 1194365338 | Bounds Family Medical | Clinic/Center | 870 Main St Ste A, Fayette, MS 39069-5695 | 2020-01-15 |
| 1720649577 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 19 Third St, Belmont, MS 38827 | 2019-06-24 |
| 1255999611 | Boa Vida Hospital of Aberdeen, Ms LLC | Clinic/Center | 400 3rd Ave 32 West, New Houlka, MS 38850 | 2019-05-31 |
| 1598238545 | South Sunflower County Hospital | Clinic/Center | 1001 West Delta, Moorhead, MS 38761 | 2019-01-02 |
| 1790272185 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 670 Ms-178, Suite 5, Sherman, MS 38869 | 2018-04-20 |
| 1124515515 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 2200 5th St N, Columbus, MS 39705-2212 | 2018-04-20 |
| 1205323698 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 815 2nd Ave N, Columbus, MS 39701-4703 | 2018-04-20 |
| Find all providers with the same taxonomy | ||||
| City | LOUISVILLE |
| Zip Code | 39339 |
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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.