KPC PROMISE HOSPITAL OF VICKSBURG LLC
NPI 1124682570
Long Term Care Hospital in Vicksburg, MS

Q: What is the provider's specialty?

The provider's specialty is Long Term Care Hospital with taxonomy code 282E00000X.

Active since April 30, 2019

2100 HIGHWAY 61 N, VICKSBURG, MS 39183(601) 883-3265 Get Directions Write a Review

NPPES record last updated: November 1, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Nov 1, 2021, Apr 30, 2019 (2 updates tracked since 2019).

Table of Contents

NPI Profile Information
Primary Taxonomy
Authorized Official
Other Providers Same Location
Frequently Asked Questions

Organization
Long Term Care Hospital

About KPC PROMISE HOSPITAL OF VICKSBURG LLC

This page provides the complete NPI Profile along with additional information for Kpc Promise Hospital Of Vicksburg Llc, a provider established in Vicksburg, Mississippi operating as a Long Term Care Hospital. The healthcare provider is registered in the NPI registry with number 1124682570 assigned on April 2019. The practitioner's primary taxonomy code is 282E00000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is William Thomas (Secretary)

NPI: 1124682570 Verify this NPI
Provider Name: KPC PROMISE HOSPITAL OF VICKSBURG LLC
Entity Type: Organization
Location Address: 2100 HIGHWAY 61 N VICKSBURG, MS 39183
Location Phone: (601) 883-3265
Mailing Address: 900 N FEDERAL HWY STE 350 BOCA RATON, FL 33432
Mailing Phone: (561) 869-6505
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 04-30-2019
Last Update Date: 11-01-2021
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Long Term Care Hospital
Taxonomy Code: 282E00000X
Type: Hospitals
Taxonomy Description: Long-term care hospitals (LTCHs) furnish extended medical and rehabilitative care to individuals who are clinically complex and have multiple acute or chronic conditions.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: WILLIAM THOMAS
Authorized Official Title: SECRETARY
Authorized Official Phone: (951) 987-8100