JEFFERSON DAVIS COMMUNITY HOSPITAL REGIONAL MEDICAL CLINIC
NPI 1417146259
Clinic/Center - Critical Access Hospital in Bassfield, MS
NPI Status: Active since October 17, 2007
Contact Information
4297 HIGHWAY 42
BASSFIELD, MS
ZIP 39421
Phone: (601) 943-5060
- Organization
- Clinic/Center
- Critical Access Hospital
- CLIA Number: 25D1067906
- CLIA Cert. Type: Rural Health Clinic
- CLIA Exp. Date: 04-26-2027
About JEFFERSON DAVIS COMMUNITY HOSPITAL REGIONAL MEDICAL CLINIC
This page provides the complete NPI Profile along with additional information for Jefferson Davis Community Hospital Regional Medical Clinic, a provider established in Bassfield, Mississippi operating as a Clinic/center, focusing in critical access hospital . The healthcare provider is registered in the NPI registry with number 1417146259 assigned on October 2007. The practitioner's primary taxonomy code is 261QC0050X with license number 16179 (MS). The provider is registered as an organization and their NPI record was last updated 19 years ago. The provider's is doing business as Jefferson Davis Community Hospital Regional Medical Clinic. The authorized official of this NPI record is Mr. Gary Lee Mccall Jr. (Coo)
- NPI
- 1417146259
- Provider Legal Name
- PRENTISS REGIONAL HOSPITAL AND ECF, INC.
- Other Organization Name
- JEFFERSON DAVIS COMMUNITY HOSPITAL REGIONAL MEDICAL CLINIC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 4297 HIGHWAY 42 BASSFIELD, MS 39421
- Location Phone
- (601) 943-5060
- Mailing Address
- PO BOX 1288 1102 ROSE ST PRENTISS, MS 39474
- Mailing Phone
- (601) 792-4276
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-17-2007
- Last Update Date
- 10-17-2007
- Code Navigator
Location Map
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
Clinic/Center Critical Access Hospital
- Taxonomy Code
- 261QC0050X
- Type
- Ambulatory Health Care Facilities
- License No.
- 16179
- License State
- MS
- Taxonomy Description
- An outpatient entity, facility, or distinct part of a facility within or affiliated with a Critical Access Hospital that provides access to primary care services for individuals in a small rural community and is Medicare certified.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 25D1067906
- Facility Type
- Rural Health Clinic
- Certificate Effective Date
- April 27, 2025
- Certificate Expiration Date
- April 26, 2027
- Laboratory Director
- MICHELE MAHAFFEY
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Jefferson Davis Community Hospital Regional Medical Clinic to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1417146259, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 51 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1417146259, enumerated as an "organization" on October 17, 2007.
The provider is located at 4297 HIGHWAY 42 BASSFIELD, MS 39421 and the phone number is (601) 943-5060.
Clinic/Center with taxonomy code 261QC0050X and a focus in Critical Access Hospital.
