NPIMap

Organization Active NPI

George County Hospital

  • Rural Acute Care Hospital
  • Lucedale, MS
National Provider Identifier
1023074028
Registry record updated Nov 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
License
11-166 Issued in MS
Legal business name
GEORGE COUNTY HOSPITAL
Practice address
859 Winter St
Lucedale, MS 39452-6603
Phone
(601) 947-3161
Fax
(601) 947-9206
NPI assigned
Apr 26, 2006
Last updated
Nov 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2010

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

Authorized official

Name
Mr. Paul A Gardner
Title
Ceo
Phone
(601) 947-9148

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X 11-166 MS Primary

Addresses

Primary practice location

859 Winter St
Lucedale, MS 39452-6603

Mailing address

PO Box 607
Lucedale, MS 39452-0607
Phone (601) 947-3161

Other identifiers 2

IdentifierTypeStateIssuer
00020290MedicaidMS
000020120OtherMSBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040604000732 MS Part B Supplier - Clinic/Group Practice 5294717013 Receives reassigned benefits from 16 practitioners
4 other NPIs on this enrollment
Practice locations: Lucedale, MS
O20071119000192 MS Part A Provider - Hospital 5294717013 Practice locations: Lucedale, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023074028. Details of each certification follow.

Hospital certification: CCN 250036

Legal name
GEORGE COUNTY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Apr 13, 2023
Beds
48
Ownership / control type
Local
Organization structure
OtherNon-profit
Enrollment address
859 Winter Street
Lucedale, MS 39452-6603
Other Hospital Practice Location
Hospital subgroups
Acute care

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

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 4

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

Care Compare: Hospital

Medicare Care Compare
Listed as
George Regional Health SystemCCN 250036 · All quality measures
Overall star rating
1 of 5
Type
Acute Care Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
George Regional Hospital10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Interoperability endpoints

  • Direct secure messaging: abhamishra@grh.medalliesdirect.net
  • Direct secure messaging: andreafykelogan@grh.medalliesdirect.net
  • Direct secure messaging: anthonynuchereno-do@grh.medalliesdirect.net
  • Direct secure messaging: brandonnichols@grh.medalliesdirect.net
  • Direct secure messaging: brookehuff-brown@grh.medalliesdirect.net
  • Direct secure messaging: bryanbennett@grh.medalliesdirect.net
  • Direct secure messaging: carmanwalley@grh.medalliesdirect.net
  • Direct secure messaging: chelseagrow@grh.medalliesdirect.net
  • Direct secure messaging: christopherclark@grh.medalliesdirect.net
  • Direct secure messaging: christopherlansdown@grh.medalliesdirect.net
  • Direct secure messaging: codydavis@grh.medalliesdirect.net
  • Direct secure messaging: courtneyburns@grh.medalliesdirect.net
  • Direct secure messaging: courtneyvalentine@grh.medalliesdirect.net
  • Direct secure messaging: crystalstafford@grh.medalliesdirect.net
  • Direct secure messaging: davidmayer@grh.medalliesdirect.net
  • Direct secure messaging: deborahhyatt@grh.medalliesdirect.net
  • Direct secure messaging: declanhegarty@grh.medalliesdirect.net
  • Direct secure messaging: deepinderburn@grh.medalliesdirect.net
  • Direct secure messaging: devenfejka@grh.medalliesdirect.net
  • Direct secure messaging: donalddoran@grh.medalliesdirect.net

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Jeff Howell Individual Corporate Director Oct 1, 2007
Wilson Williams Individual Corporate Director Oct 1, 2007
Margaret Dixon Individual Corporate Director Oct 1, 2007
Greg Havard Individual Corporate DirectorCeo Jan 12, 2015
W-2 Managing EmployeeCeo Jan 12, 2015
Operational/Managerial ControlCeo Jan 12, 2015 100%
Robert Langley Individual Corporate Director Oct 1, 2007

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Wiggins Primary CareWiggins, MS, CCN 258527 Rural health clinic 5% Or Greater Direct Ownership Interest Jun 1, 2005
Community Medical CenterLucedale, MS, CCN 253988 Rural health clinic 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jul 1, 1993
Jul 1, 1993
Obstetrics & Gynecology AssociatesLucedale, MS, CCN 253481 Rural health clinic 5% Or Greater Direct Ownership Interest Jun 23, 1997
Greene County Family Medical ClinicLeakesville, MS, CCN 258544 Rural health clinic 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Aug 1, 2007
Aug 1, 2024

Owned or controlled facilities with NPI records 4

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

Practitioners & affiliated clinicians

Practitioners 74

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 74

Affiliated clinicians 111

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

View all 111

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289779200000",
    "number": "1023074028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 607",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "394520607",
            "telephone_number": "601-947-3161",
            "fax_number": "601-947-9206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 WINTER ST",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "394526603",
            "telephone_number": "601-947-3161",
            "fax_number": "601-947-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2010-11-15",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-947-9148",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "MS",
            "license": "11-166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00020290",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000020120",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lucedale, MS

Sources for this page

Verify at the official NPI Registry.