SCOTT REGIONAL MEDICAL CENTER, INC. (NPI# 1679831531) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679831531 |
| Entity Type | Organization |
| Organization Name | SCOTT REGIONAL MEDICAL CENTER, INC. |
| Other Organization Name | PRIMARY HEALTH CARE |
| Practice Address |
1080 Highway 35 S Forest MS 39074-9423 |
| Mailing Address |
Po Box 2065 Meridian MS 39302-2065 |
| Practice Telephone | 6014693555 |
| Practice Fax Number | 6014693584 |
| Mailing Telephone | 6017034282 |
| Mailing Fax Number | 6017033080 |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2018-02-23 |
| Authorized Official Name | DON LARKIN KENNEDY (PRESIDENT) |
| Authorized Official Telephone | 6017039614 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Primary Health Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003166117 | Scott Regional Medical Center, Inc. | Midwife | 321 Hwy 13 South, Morton, MS 39117 | 2012-09-17 |
| 1932478476 | Scott Regional Medical Center, Inc. | Midwife | 24489 Highway 80, Lake, MS 39092-3511 | 2011-12-28 |
| 1134278435 | Scott Regional Medical Center, Inc. | General Acute Care Hospital | 317 Highway 13 S, Morton, MS 39117-3353 | 2007-01-09 |
| 1639228547 | Scott Regional Medical Center, Inc. | Medicare Defined Swing Bed Unit | 317 Highway 13 S, Morton, MS 39117-3353 | 2007-01-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SCOTT REGIONAL MEDICAL CENTER, INC. | 1314 19th Ave, Meridian, MS 39301-4116 |
| Street Address |
1080 HIGHWAY 35 S |
| City | FOREST |
| State | MS |
| Zip Code | 39074-9423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871575852 | Bernard Gayle Harrell | Family Medicine | 1080 Highway 35 S, Forest, MS 39074-9423 | 2005-11-16 |
| 1184978140 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 1080 Highway 35 S, Forest, MS 39074-9423 | 2012-10-30 |
| 1710922638 | Marion Jewett Sorrels | Family Medicine | 1080 Highway 35 S, Forest, MS 39074-9423 | 2006-06-17 |
| 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 | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245489186 | Independent Healthcare Management, Inc. | Clinic/Center | 526 Deerfield Dr, Suite C, Forest, MS 39074-6005 | 2008-09-16 |
| 1841447554 | Total Care Clinic | Clinic/Center | 526 Deerfield Dr., Forest, MS 39074-9999 | 2008-08-25 |
| 1255376729 | Independent Healthcare Management, Inc. | Clinic/Center | 330 N Broad St, Forest, MS 39074-3508 | 2006-06-18 |
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| 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 | ||||
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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.