Organization Active NPI

Wesley Health System LLC

Doing business as Merit Health Wesley

  • Psychiatric Hospital Unit
  • Hattiesburg, MS
National Provider Identifier
1053776591
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
12023 Issued in MS
Legal business name
WESLEY HEALTH SYSTEM LLC
Doing business as
Merit Health Wesley
Practice address
5001 Hardy St
Hattiesburg, MS 39402-1308
Phone
(601) 268-8000
Fax
(601) 268-5008
NPI assigned
Dec 29, 2015
Last updated
Apr 22, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
WESLEY HEALTH SYSTEM LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Authorized official

Name
Paula M Lalor
Title
Director/Delegated Official
Phone
(629) 215-3953

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 12023 MS Primary

Addresses

Primary practice location

5001 Hardy St
Hattiesburg, MS 39402-1308

Mailing address

5001 Hardy St
Hattiesburg, MS 39402-1308
Phone (601) 268-8000

Other names 1

  • Merit Health Wesley Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160217000170 MS Part A Provider - Hospital 4587656103 Practice locations: Hattiesburg, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053776591. Details of each certification follow.

Hospital certification: CCN 25S094

Legal name
WESLEY HEALTH SYSTEM LLC
Doing business as
MERIT HEALTH WESLEY
Organization structure
LLCProprietary
Incorporated
Jul 9, 1997 in DE
Enrollment address
5001 Hardy St
Hattiesburg, MS 39402-1308
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric

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

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Wesley Medical Center4 organizations share this tax ID, including this one
Part of
Wesley Medical Center

Other organizations with this tax ID 3

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

6026 U S Highway 98
Slp Ctr
Hattiesburg, MS 39402
Phone (601) 271-2204

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Kevin J Hammons Individual Corporate OfficerPresident/Board Member Jan 1, 2020
Corporate DirectorPresident/Board Member Jan 1, 2020
QHG Georgia Holdings, Inc. Organization, Franklin, TN Corporation 5% Or Greater Indirect Ownership Interest Mar 1, 2016 100%
Triad Nevada Holdings LLC Organization, Franklin, TN LLC 5% Or Greater Indirect Ownership Interest Mar 1, 2016 100%
Nathaniel K Summar Individual Corporate DirectorVP Revenue Management Jul 15, 2017
Justin D Pitt Individual Corporate OfficerExec VP/Assist Sec/Board Member Mar 1, 2022
Corporate DirectorExec VP/Assist Sec/Board Member Mar 1, 2022
William Bradley Cash Individual Corporate OfficerExec VP Jun 1, 2018
Hma-Tri Holdings LLC Organization, Franklin, TN LLC 5% Or Greater Indirect Ownership Interest Mar 1, 2016 100%
Community Health Systems Inc Organization, Franklin, TN Corporation 5% Or Greater Indirect Ownership Interest Mar 1, 2016 100%
Travis Riley Sisson Individual W-2 Managing EmployeeCeo Mar 4, 2024
Jason Kevin Johnson Individual Corporate OfficerSenior VP Jan 6, 2020
Roman Gabriel Ottinger Individual Corporate OfficerSenior VP/Treasurer Jan 6, 2020
QHG of Forrest County Inc Organization, Franklin, TN Corporation 5% Or Greater Direct Ownership Interest Mar 1, 2016 5%
Triad Holdings V LLC Organization, Franklin, TN LLC 5% Or Greater Indirect Ownership Interest Mar 1, 2016 100%
Paula M Lalor Individual Corporate DirectorDirector PFS/Delegated Official Apr 8, 2017
Triad Healthcare LLC Organization, Franklin, TN Corporation 5% Or Greater Indirect Ownership Interest Mar 1, 2016 100%
Tennyson Holdings LLC Organization, Franklin, TN LLC 5% Or Greater Indirect Ownership Interest Mar 1, 2016 100%
Edna S Buffington-Price Individual Corporate DirectorVP/Authorized Official Mar 1, 2022
QHG of Hattiesburg Inc Organization, Franklin, TN Corporation 5% Or Greater Direct Ownership Interest Mar 1, 2016 95%
NC-DSH LLC Organization, Franklin, TN LLC 5% Or Greater Indirect Ownership Interest Mar 1, 2016 100%
Christopher G Cobb Individual Corporate OfficerVP/Secretary Apr 26, 2013
CHS Community Health Systems Inc Organization, Franklin, TN Corporation 5% Or Greater Indirect Ownership Interest Mar 1, 2016 100%

Facilities with the same owner 120

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

View all 120

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1451347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1053776591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 HARDY ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021308",
            "telephone_number": "601-268-8000",
            "fax_number": "601-268-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 HARDY ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021308",
            "telephone_number": "601-268-8000",
            "fax_number": "601-268-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESLEY HEALTH SYSTEM LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WESLEY HEALTH SYSTEM LLC",
        "enumeration_date": "2015-12-29",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "LALOR",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR/DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "629-215-3953"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "MS",
            "license": "12023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Merit Health Wesley",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Merit Health Wesley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.