PROMISE HOSPITAL OF VICKSBURG INC (NPI# 1932168416) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932168416 |
| Entity Type | Organization |
| Organization Name | PROMISE HOSPITAL OF VICKSBURG INC |
| Practice Address |
2100 Highway 61 N Fl 6 Vicksburg MS 39183 |
| Mailing Address |
999 Yamato Road 3rd Floor Boca Raton FL 33431 |
| Practice Telephone | 6018833265 |
| Practice Fax Number | 6018833279 |
| Mailing Telephone | 5618693100 |
| Mailing Fax Number | 5618260171 |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2018-05-16 |
| Authorized Official Name | MR. JAMES HOPWOOD (CFO) |
| Authorized Official Telephone | 5618693100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282E00000X | Long Term Care Hospital | 22-334 | MS | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | BLUE CROSS REGULAR PROV # | 000020813 | 01 |
| MS | BLUE CROSS STATE EMPLOYEE | 000021834 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1111 N Frontage Rd, 2nd Floor, Vicksburg, MS 391805102 | 6016193526 | 6016193071 |
| Street Address |
2100 HIGHWAY 61 N FL 6 |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39183 |
| 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 |
| 1164945374 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2310 Clay St, Vicksburg, MS 39183 | 2017-07-19 |
| 1255777025 | Joyce Wanjugu Muruthi | Obstetrics & Gynecology | 2100 Highway 61 N, Vicksburg, MS 39183 | 2013-05-20 |
| 1811244858 | Life Balance Clinic LLC | Social Worker | 1107 Openwood St, Vicksburg, MS 39183 | 2012-08-09 |
| Find all providers in zip 39183 | ||||
| Taxonomy Code | 282E00000X |
| Grouping | Hospitals |
| Classification | Long Term Care Hospital |
| Long-term care hospitals (LTCHs) furnish extended medical and rehabilitative care to individuals who are clinically complex and have multiple acute or chronic conditions. |
| Notes: Source: American Hospital Association [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124682570 | Kpc Promise Hospital of Vicksburg LLC | Long Term Care Hospital | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2019-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730240011 | Regency Hospital of Southern Mississippi LLC | Long Term Care Hospital | 220 27th Avenue, Hattiesburg, MS 39401-7165 | 2006-12-12 |
| 1982606570 | Regency Hospital of Hattiesburg, LLC | Long Term Care Hospital | 125 S 25th Ave, Hattiesburg, MS 39401-6031 | 2005-08-12 |
| 1952303778 | Regency Hospital Company of Meridian, LLC | Long Term Care Hospital | 1102 Constitution Ave, 2nd Floor, Meridian, MS 39301-4001 | 2005-08-11 |
| 1518967280 | Select Specialty Hospital - Gulf Coast Inc | Long Term Care Hospital | 1520 Broad Ave, Gulfport, MS 39501-3601 | 2005-07-26 |
| 1255330163 | Select Specialty Hospital - Jackson Inc | Long Term Care Hospital | 5903 Ridgewood Rd, Jackson, MS 39211-3700 | 2005-07-21 |
| 1619326014 | Select Specialty Hospital - Belhaven, LLC | Long Term Care Hospital | 1225 N State St, Jackson, MS 39202-2064 | 2016-06-07 |
| 1255661203 | Select Employment Services, Inc | Long Term Care Hospital | 1520 Broad Ave, Gulfport, MS 39501-3601 | 2010-01-13 |
| 1619109535 | Ltac Hospital of Greenwood, LLC | Long Term Care Hospital | 1401 River Rd, 2nd Floor, Greenwood, MS 38930-4030 | 2009-08-11 |
| 1154560290 | Allegiance Specialty Hospital of Greenville, LLC | Long Term Care Hospital | 300 Washington Ave, Greenville, MS 38701-3614 | 2009-02-12 |
| 1275700064 | Forrest County General Hospital | Long Term Care Hospital | 130 Highland Pkwy, Picayune, MS 39466-5574 | 2008-05-12 |
| 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.