NPIMap

Organization Active NPI

Scott Regional Medical Center, Inc.

Doing business as Ochsner Health Center- Morton

  • Rural Health Clinic/Center
  • Morton, MS
National Provider Identifier
1003166117
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SCOTT REGIONAL MEDICAL CENTER, INC.
Doing business as
Ochsner Health Center- Morton
Practice address
321 Hwy 13 South
Morton, MS 39117
Phone
(601) 732-8612
Fax
(601) 732-1957
NPI assigned
Sep 17, 2012
Last updated
Apr 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Don Larkin Kennedy
Title
Regional Ceo
Phone
(601) 703-9614

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
MidwifeGroup: 193200000X MULTI-SPECIALTY GROUP 176B00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Rural Health Clinic/Center 261QR1300X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

321 Hwy 13 South
Morton, MS 39117

Mailing address

Dept 3029 PO Box 1000
Memphis, TN 38148-3029
Phone (601) 213-3010

Other names 1

  • Ochsner Health Center- Morton Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080423000448 MS Part B Supplier - Clinic/Group Practice 0648366260 Receives reassigned benefits from 57 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Forest, MS; Lake, MS; Morton, MS
O20130722000067 MS Part A Provider - Rural Health Clinic 0648366260 Practice locations: Morton, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003166117. Details of each certification follow.

Rural health clinic certification: CCN 258577

Legal name
SCOTT REGIONAL MEDICAL CENTER, INC.
Doing business as
OCHSNER HEALTH CENTER- MORTON
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 18, 2013
Last certification
Oct 5, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Aug 1, 2008 in MS
Enrollment address
321 Highway 13 S
Morton, MS 39117-3353
Related CCNs
251323

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2045988Ochsner Health Center - Morton321 Hwy 13 S, Morton, MS 39117Certificate of waiverJun 6, 2027

National Provider Directory

National Provider Directory
Tax ID family
Scott Regional Medical Center Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1080 Highway 35 S
Forest, MS 39074
Phone (601) 469-3555

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Johnathan Y Lee Individual Corporate DirectorGoverning Board, Rush Health System Jul 1, 2022
Operational/Managerial ControlGoverning Board, Rush Health System Jul 1, 2022
Michael F Hulefeld Individual Corporate OfficerPresident, Coo Nov 1, 2022
Corporate DirectorMember of Governing Board Jul 1, 2022
Operational/Managerial ControlMember of Governing Board Jul 1, 2022
Faye Martin Individual Corporate DirectorGoverning Board, Rush Health System Jul 1, 2022
Operational/Managerial ControlGoverning Board, Rush Health System Jul 1, 2022
Alan Gartrell Individual Corporate DirectorGoverning Board, Rush Health System Jul 1, 2022
Operational/Managerial ControlGoverning Board, Rush Health System Jul 1, 2022
Peter C November Individual Corporate OfficerChief Executive Officer Nov 1, 2022
Corporate DirectorMember of Governing Board Jul 1, 2022
Operational/Managerial ControlMember of Governing Board Jul 1, 2022
Heather Davis Individual W-2 Managing EmployeeAvp Scott Hospital Jul 1, 2022
Operational/Managerial ControlAvp Scott Hospital Jul 1, 2022
James M Molloy Individual Corporate OfficerExecutive VP, Cfo, Treasurer Jan 1, 2024
Darrell Wildman Individual Corporate DirectorGoverning Board, Rush Health System Jul 1, 2022
Operational/Managerial ControlGoverning Board, Rush Health System Jul 1, 2022
Ochsner Clinic Foundation Organization, New Orleans, LA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2022 100%
Operational/Managerial Control Jul 1, 2022
Don L Kennedy Individual Corporate OfficerRegional Chief Executive Officer Jul 1, 2022
W-2 Managing EmployeeRegional Chief Executive Officer, R Jul 1, 2022
Operational/Managerial ControlRegional Chief Executive Officer, R Jul 1, 2022
Rush Health Systems Inc Organization, Meridian, MS Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2022 100%
Operational/Managerial Control Nov 1, 2012
David L Butler Individual Corporate OfficerChief Financial Officer, Rush He Jul 1, 2022
W-2 Managing EmployeeChief Financial Officer, Rush Healt Jul 1, 2022
Operational/Managerial ControlChief Financial Officer, Rush Healt Jul 1, 2022

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 75

Facilities that share an organizational owner with 5% or greater ownership or operational control.

  • Kemper Cah, Inc

    dba Ochsner Health Center-Hwy 39

    • Rural Health Clinic/Center
    • Meridian, MS
    • NPI 1275879314

    Ochsner Clinic Foundation, Rush Health Systems Inc

    CMS ownership
  • Kemper Cah, Inc.

    dba Ochsner Stennis Hospital Swing Bed

    • Medicare Defined Swing Bed Hospital Unit
    • De Kalb, MS
    • NPI 1518260322

    Ochsner Clinic Foundation, Rush Health Systems Inc

    CMS ownership
  • Kemper Cah, Inc.

    dba Ochsner Stennis Hospital

    • Critical Access Hospital
    • De Kalb, MS
    • NPI 1679875645

    Ochsner Clinic Foundation, Rush Health Systems Inc

    CMS ownership
  • Kemper Cah, Inc.

    dba Ochsner Health Center-Dekalb

    • Rural Health Clinic/Center
    • De Kalb, MS
    • NPI 1912348616

    Ochsner Clinic Foundation, Rush Health Systems Inc

    CMS ownership
  • Kemper, Cah, Inc.

    dba Ochsner Health Center-Marion

    • Rural Health Clinic/Center
    • Marion, MS
    • NPI 1669812962

    Rush Health Systems Inc

    CMS ownership
  • Laird Hospital, Inc

    dba Ochsner Health Center- Collinsville

    • Rural Health Clinic/Center
    • Collinsville, MS
    • NPI 1073959375

    Ochsner Clinic Foundation, Rush Health Systems Inc

    CMS ownership
  • Laird Hospital, Inc.

    dba Ochsner Laird Hospital Swing Bed

    • Medicare Defined Swing Bed Hospital Unit
    • Union, MS
    • NPI 1033176276

    Ochsner Clinic Foundation, Rush Health Systems Inc

    CMS ownership
  • Laird Hospital, Inc.

    dba Ochsner Health Center- Decatur

    • Rural Health Clinic/Center
    • Decatur, MS
    • NPI 1033460878

    Ochsner Clinic Foundation, Rush Health Systems Inc

    CMS ownership
  • Laird Hospital, Inc.

    dba Ochsner Childrens Health Center

    • Rural Health Clinic/Center
    • Meridian, MS
    • NPI 1114330347

    Ochsner Clinic Foundation, Rush Health Systems Inc

    CMS ownership
  • Laird Hospital, Inc.

    dba Ochsner Health Center- Newton

    • Rural Health Clinic/Center
    • Newton, MS
    • NPI 1194323170

    Ochsner Clinic Foundation, Rush Health Systems Inc

    CMS ownership
  • Laird Hospital, Inc.

    dba Ochsner Health Center- Philadelphia

    • Rural Health Clinic/Center
    • Philadelphia, MS
    • NPI 1275873572

    Ochsner Clinic Foundation, Rush Health Systems Inc

    CMS ownership
  • Laird Hospital, Inc.

    dba Ochsner Laird Hospital

    • Critical Access Hospital
    • Union, MS
    • NPI 1518924752

    Ochsner Clinic Foundation, Rush Health Systems Inc

    CMS ownership
View all 75

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682035200000",
    "number": "1003166117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 3029 PO BOX 1000",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381483029",
            "telephone_number": "601-213-3010",
            "fax_number": "601-213-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 HWY 13 SOUTH",
            "city": "MORTON",
            "state": "MS",
            "postal_code": "39117",
            "telephone_number": "601-732-8612",
            "fax_number": "601-732-1957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT REGIONAL MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-17",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "DON",
        "authorized_official_middle_name": "LARKIN",
        "authorized_official_title_or_position": "REGIONAL CEO",
        "authorized_official_telephone_number": "601-703-9614"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Ochsner Health Center- Morton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Morton, MS

Sources for this page

Verify at the official NPI Registry.