NPIMap

Organization Active NPI

North Mississippi Medical Center, Inc.

Doing business as North MS Medical Center Home Health Agency

  • Home Health Agency
  • Tupelo, MS
National Provider Identifier
1003871344
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
8481 Issued in MS
Legal business name
NORTH MISSISSIPPI MEDICAL CENTER, INC.
Doing business as
North MS Medical Center Home Health Agency
Practice address
424 East President Street
Tupelo, MS 38801-5500
Phone
(662) 377-2138
Fax
(662) 377-7983
NPI assigned
Apr 19, 2006
Last updated
Oct 8, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH MISSISSIPPI MEDICAL CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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

Authorized official

Name
Mr. Joseph A Reppert
Title
Cfo
Phone
(662) 377-3978

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 8481 MS Primary

Addresses

Primary practice location

424 East President Street
Tupelo, MS 38801-5500

Mailing address

830 S Gloster St
Tupelo, MS 38801-4934
Phone (662) 377-2138

Other names 1

  • North MS Medical Center Home Health Agency Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071120000184 MS Part A Provider - Home Health Agency 9931010600 Practice locations: Tupelo, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003871344. Details of each certification follow.

Home health agency certification: CCN 257002

Legal name
NORTH MISSISSIPPI MEDICAL CENTER, INC.
Doing business as
NORTH MS MEDICAL CENTER HOME HEALTH AGENCY
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 1, 1966
Last certification
Nov 29, 2017
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
Apr 2, 1982 in DE
Enrollment address
424 East President Street
Tupelo, MS 38801

Other NPIs with the same Medicare PAC ID 8

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
North Mississippi Medical Ctr HHACCN 257002 · All quality measures
Overall star rating
3 of 5
Ownership
Non-Profit
Certified
Jul 1, 1966
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
North Mississippi Med C65 organizations share this tax ID, including this one
Part of
North Mississippi Med C

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

812 Garfield St
Tupelo, MS 38801
Phone (601) 844-6768

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Barry D Bertolet Individual Corporate DirectorBoard Member Oct 1, 2021
Calude Waycaster Individual Corporate DirectorBoard Member Oct 1, 2021
William H Milam Individual Corporate Director Jul 1, 1966
North Mississippi Health Services Inc Organization, Tupelo, MS 5% Or Greater Direct Ownership Interest Jul 1, 1966
Bruce J Toppin Individual Corporate Officer Jul 1, 1966
Lewis Whitfield Individual Corporate DirectorBoard Member Oct 1, 2021
Sharon D Nobles Individual Corporate OfficerTreasurer Apr 4, 2017
Samuel Jeffery Sliman Individual Corporate DirectorBoard Member Oct 1, 2021
Samuel C Pace Individual Corporate DirectorBoard Member Oct 1, 2021
Michael S Spees Individual Corporate DirectorCeo Feb 1, 2014
John Wheeler Individual Corporate DirectorBoard Member Oct 1, 2021
Gary Lynn Sparkman Individual Corporate DirectorBoard Member Oct 1, 2021
Chris Rogers Individual Corporate Director Jul 1, 1966
David Copenhaver Individual Corporate DirectorBoard Member Oct 1, 2021
Chester K White Individual Corporate DirectorBoard Member Oct 1, 2021
David Wilson Individual W-2 Managing EmployeeAdministrator Mar 30, 2015

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Baldwyn Nursing FacilityBaldwyn, MS, CCN 255161 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Mar 16, 2009
Mar 16, 2009
Mar 16, 2009
Childrens Clinic - TupeloTupelo, MS, CCN 258551 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Aug 24, 1992

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 33

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

View all 33

Practitioners & affiliated clinicians

Affiliated clinicians 213

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 213

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570492800000",
    "number": "1003871344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014934",
            "telephone_number": "662-377-2138",
            "fax_number": "662-377-7983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 EAST PRESIDENT STREET",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388015500",
            "telephone_number": "662-377-2138",
            "fax_number": "662-377-7983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH MISSISSIPPI MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH MISSISSIPPI MEDICAL CENTER, INC.",
        "enumeration_date": "2006-04-19",
        "last_updated": "2019-10-08",
        "status": "A",
        "authorized_official_last_name": "REPPERT",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "662-377-3978",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MS",
            "license": "8481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North MS Medical Center Home Health Agency",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North MS Medical Center Home Health Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.