NPIMap

Organization Active NPI

Covington County Hospital

Doing business as Family Care Express

  • Rural Health Clinic/Center
  • Collins, MS
National Provider Identifier
1013205350
Registry record updated Jul 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
COVINGTON COUNTY HOSPITAL
Doing business as
Family Care Express
Practice address
3275 Hwy 49
Suite E
Collins, MS 39428
Phone
(601) 765-6711
Fax
(601) 765-2808
NPI assigned
Jul 20, 2011
Last updated
Jul 20, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2011

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

Authorized official

Name
Kirstie Evans
Title
Cfo
Phone
(601) 765-6711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

3275 Hwy 49
Suite E
Collins, MS 39428

Mailing address

3275 Hwy 49
Suite E
Collins, MS 39428
Phone (601) 765-6711

Other names 1

  • Family Care Express Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040203000816 MS Part B Supplier - Clinic/Group Practice 4183517253 Receives reassigned benefits from 71 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Collins, MS; Sumrall, MS
O20111118000184 MS Part A Provider - Rural Health Clinic 4183517253 Practice locations: Collins, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013205350. Details of each certification follow.

Rural health clinic certification: CCN 258562

Legal name
COVINGTON COUNTY HOSPITAL
Doing business as
FAMILY CARE EXPRESS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 23, 2012
Last certification
Mar 9, 2026
Ownership / control type
Non-profit – church related
Organization structure
GovernmentNon-profit
Incorporated
Jul 1, 1951 in MS
Enrollment address
3275 Hwy 49 Ste E
Family Care Express
Collins, MS 39428-3275
Related CCNs
251325

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

Other NPIs with the same Medicare PAC ID 15

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

View all 15

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
25D2031679Family Care Express3275 Hwy 49 Ste E, Collins, MS 39428Provider-performed microscopyOct 24, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Greg Sanford Individual Corporate DirectorBoard Member Jan 15, 2008 100%
James McPhail Individual Corporate DirectorBoard Member Jan 15, 2009 100%
Covington County Hospital Organization, Collins, MS Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2016 100%
Operational/Managerial Control Jan 1, 2016 100%
Charlie Anglin Individual Corporate DirectorBoard Member Oct 8, 2007 100%
Robert Johnson Individual Corporate DirectorBoard Member-President Jan 23, 2007 100%
Greg Sullivan Individual Corporate DirectorBoard Member Oct 8, 2007 100%
Missy L Gamber Individual Contracted Managing EmployeeDirector of Credentialing Jan 1, 2016 100%
Gregg Gibbes Individual Corporate OfficerCeo Apr 28, 2016 100%
W-2 Managing EmployeeCeo Apr 28, 2016 100%
Operational/Managerial ControlCeo Apr 28, 2016 100%
Everlean Booth Individual Corporate DirectorBoard Member-Secretary Nov 18, 2005 100%

Owners & managing parties with NPI records 15

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

  • Covington County Hospital

    dba Smith County EH Pro Fees

    • Emergency Medical Services (Emergency Medicine) Physician
    • Raleigh, MS
    • NPI 1003654567

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Covington County Hospital

    dba Smith County Emergency Hospital

    • Rural Acute Care Hospital
    • Raleigh, MS
    • NPI 1043051543

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Covington County Hospital

    dba Arrington Living Center

    • Skilled Nursing Facility
    • Collins, MS
    • NPI 1053615518

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Covington County Hospital

    dba CCH Clinic Seminary

    • Rural Health Clinic/Center
    • Seminary, MS
    • NPI 1134435498

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Covington County Hospital
    • Critical Access Hospital
    • Collins, MS
    • NPI 1215965249

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Covington County Hospital
    • Psychiatric Hospital Unit
    • Collins, MS
    • NPI 1225150436

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Covington County Hospital

    dba Family Care Magee Tuscan Towers

    • Rural Health Clinic/Center
    • Magee, MS
    • NPI 1225704208

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Covington County Hospital

    dba CCH Clinic Taylorsville

    • Rural Health Clinic/Center
    • Taylorsville, MS
    • NPI 1306460282

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Covington County Hospital

    dba Green Tree Family Medical Clinic

    • Rural Health Clinic/Center
    • Mount Olive, MS
    • NPI 1336447861

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Covington County Hospital

    dba Family Care Magee

    • Rural Health Clinic/Center
    • Magee, MS
    • NPI 1346822772

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Covington County Hospital

    dba Family Care of Main Street

    • Rural Health Clinic/Center
    • Collins, MS
    • NPI 1518260330

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Covington County Hospital

    dba CCH Clinic Family Medical

    • Rural Health Clinic/Center
    • Collins, MS
    • NPI 1598769044

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
View all 15

All facility ownership & control disclosures 7

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

FacilityTypeRoleSince
Covington County HospitalCollins, MS, CCN 25M325 Hospital 5% Or Greater Direct Ownership Interest Jan 1, 2016
Arrington Living CenterCollins, MS, CCN 255331 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 May 1, 2011
May 1, 2011
Family Medical AssociatesCollins, MS, CCN 253497 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2016
CCH Clinic MageeMagee, MS, CCN 258597 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Mar 1, 2018
Mar 1, 2018
Express Care SumrallSumrall, MS, CCN 258644 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2020
Family Care of MageeMagee, MS, CCN 258662 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 4, 2021
Jan 4, 2021
Family Care Magee Tuscan TowersMagee, MS, CCN 258660 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Sep 1, 2021
Sep 1, 2021

Owned or controlled facilities with NPI records 7

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

Facilities with the same owner 7

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

Practitioners & affiliated clinicians

Practitioners 20

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 20

NPI Registry JSON

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311120000000",
    "number": "1013205350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3275 HWY 49",
            "address_2": "SUITE E",
            "city": "COLLINS",
            "state": "MS",
            "postal_code": "39428",
            "telephone_number": "601-765-6711",
            "fax_number": "601-765-2808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3275 HWY 49",
            "address_2": "SUITE E",
            "city": "COLLINS",
            "state": "MS",
            "postal_code": "39428",
            "telephone_number": "601-765-6711",
            "fax_number": "601-765-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVINGTON COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-20",
        "last_updated": "2011-07-20",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "KIRSTIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "601-765-6711"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Care Express",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Collins, MS

Sources for this page

Verify at the official NPI Registry.