VICKSBURG HEALTHCARE LLC (NPI# 1659394666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659394666 |
| Entity Type | Organization |
| Organization Name | VICKSBURG HEALTHCARE LLC |
| Other Organization Name | RIVER REGION HEALTH SYSTEM |
| Practice Address |
2100 Highway 61 N Vicksburg MS 39183-8211 |
| Practice Telephone | 6018835175 |
| Practice Fax Number | 6018835197 |
| Mailing Telephone | 6018835175 |
| Mailing Fax Number | 6018835197 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | REBECCA HURLEY (SENIOR VICE PRESIDENT) |
| Authorized Official Telephone | 2144733993 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09015632 | 05 |
| Other Name | Type Code |
|---|---|
| River Region Health System | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740228881 | Vicksburg Healthcare LLC | Psychiatric Unit | 1111 N Frontage Rd, Vicksburg, MS 39180-5102 | 2006-06-02 |
| 1639799430 | Vicksburg Healthcare LLC | Clinical Medical Laboratory | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2020-04-21 |
| 1629084058 | Vicksburg Healthcare LLC | Emergency Medicine | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2006-07-31 |
| 1659319796 | Vicksburg Healthcare LLC | Rehabilitation Unit | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2006-06-02 |
| 1568400604 | Vicksburg Healthcare LLC | Skilled Nursing Facility | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2006-06-02 |
| 1215981303 | Vicksburg Healthcare LLC | General Acute Care Hospital | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2006-05-21 |
| 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 |
| 1124682570 | Kpc Promise Hospital of Vicksburg LLC | Long Term Care Hospital | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2019-04-30 |
| 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 |
| 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 | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477677458 | Olatunji Jonathan Oluwatade | Emergency Medicine | 2080 S, Frontage Rd., Suite100, Vicksburg, MS 39180-5883 | 2007-03-16 |
| 1396776514 | Deborah A Hoover | Emergency Medicine | 4077 Pemberton Square Blvd, Vicksburg, MS 39180-5580 | 2006-07-05 |
| 1649624693 | Brandon Mizell | Emergency Medicine | 1907 Mission 66, Vicksburg, MS 39180-3711 | 2016-04-15 |
| 1487943395 | River Physicians Group, LLC | Emergency Medicine | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2011-03-31 |
| 1366678211 | Thomas A Howard | Emergency Medicine | 13326 N Blvd, Vicksburg, MI 49097-1514 | 2009-06-05 |
| 1083860324 | Kimberly Fuller | Emergency Medicine | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2008-08-18 |
| 1114196664 | Vicksburg Emergency Physicians LLP | Emergency Medicine | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2008-02-28 |
| 1245431493 | Brandon J Craft | Emergency Medicine | 2080 S Frontage Rd, Vicksburg, MS 39180-5328 | 2007-05-29 |
| 1629084058 | Vicksburg Healthcare LLC | Emergency Medicine | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2006-07-31 |
| 1265456206 | William E Johnston Jr. | Emergency Medicine | 1901 Mission 66, Vicksburg, MS 39180-3711 | 2006-07-26 |
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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.