NPIMap

Organization Active NPI

Baptist Memorial Hospital-Huntingdon

Doing business as Baptist Memorial Hospital - Carroll County

  • Psychiatric Hospital Unit
  • Huntingdon, TN
National Provider Identifier
1013324425
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
0000000010 Issued in TN
Legal business name
BAPTIST MEMORIAL HOSPITAL-HUNTINGDON
Doing business as
Baptist Memorial Hospital - Carroll County
Practice address
631 RB Wilson Dr
Huntingdon, TN 38344-1727
Phone
(731) 986-4461
NPI assigned
Jul 17, 2014
Last updated
Oct 1, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
BAPTIST MEMORIAL HEALTH CARE CORP.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Authorized official

Name
Gregory M Duckett
Title
Sr VP / Clo
Phone
(901) 227-5233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 0000000010 TN Primary

Addresses

Primary practice location

631 RB Wilson Dr
Huntingdon, TN 38344-1727

Mailing address

350 N Humphreys Blvd
Memphis, TN 38120-2177
Phone (731) 986-4461

Other names 1

  • Baptist Memorial Hospital - Carroll County Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20140912000691 TN Part A Provider - Hospital 4082509757 Practice locations: Huntingdon, TN
O20180927003364 TN Part B Supplier - Clinic/Group Practice 4082509757 Receives reassigned benefits from 25 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jackson, TN; Huntingdon, TN
O20200819002376 TN Part B Supplier - Intensive Cardiac Rehabilitation 4082509757 Receives reassigned benefits from 1 practitioner
Practice locations: Huntingdon, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013324425. Details of each certification follow.

Hospital certification: CCN 44S016

Legal name
BAPTIST MEMORIAL HOSPITAL-HUNTINGDON
Doing business as
BMH-CARROLL COUNTY
Organization structure
CorporationNon-profit
Incorporated
Feb 28, 1983 in TN
Enrollment address
631 RB Wilson Dr
Huntingdon, TN 38344-1727
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

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

Other NPIs with the same Medicare PAC ID 3

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.

National Provider Directory

National Provider Directory
Part of
Baptist Memorial Health Care Corp

Networks

  • KY PPO

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Jason M Little Individual Corporate OfficerPresident Aug 21, 2020
Natalie Porter Individual Corporate Director Aug 21, 2020
John Wright Individual Corporate DirectorBoard Member Feb 24, 2021
Susan Breeden Individual Corporate Director Feb 20, 2004
W-2 Managing Employee Dec 29, 1996
Operational/Managerial Control Oct 12, 2012
Arthur Maples Individual Corporate Director Aug 21, 2020
Baptist Memorial Hospital-Huntingdon Organization, Huntingdon, TN Non-profit 5% Or Greater Direct Ownership Interest Feb 28, 1983
Gregory M Duckett Individual Corporate Officer Jan 1, 2000
Corporate Director Jan 1, 2000
Larry L Nicholson Individual Corporate Director Oct 12, 2012
Mike Cary Individual Corporate Director Oct 12, 2012
Baptist Memorial Health Care Corporation Organization, Memphis, TN Non-profit 5% Or Greater Indirect Ownership Interest Oct 12, 2012
Other Oct 12, 2012

Owners & managing parties with NPI records 4

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
Baptist Memorial Hospital - Carroll CountyHuntingdon, TN, CCN 440016 Hospital 5% Or Greater Direct Ownership Interest Feb 28, 1983
Baptist Memorial Hospital-HuntingdonHuntingdon, TN, CCN 44U016 Hospital 5% Or Greater Direct Ownership Interest (100%) Feb 28, 1983

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 47

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

View all 47

Practitioners & affiliated clinicians

Practitioners 30

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 30

NPI Registry JSON

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601510400000",
    "number": "1013324425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N HUMPHREYS BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202177",
            "telephone_number": "731-986-4461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 RB WILSON DR",
            "city": "HUNTINGDON",
            "state": "TN",
            "postal_code": "383441727",
            "telephone_number": "731-986-4461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST MEMORIAL HOSPITAL-HUNTINGDON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAPTIST MEMORIAL HEALTH CARE CORP.",
        "enumeration_date": "2014-07-17",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A",
        "authorized_official_last_name": "DUCKETT",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SR VP / CLO",
        "authorized_official_telephone_number": "901-227-5233"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "TN",
            "license": "0000000010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Memorial Hospital - Carroll County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntingdon, TN

Sources for this page

Verify at the official NPI Registry.