NPIMap

Organization Active NPI

Copiah County Medical Center

  • Critical Access Hospital
  • Hazlehurst, MS
National Provider Identifier
1083039663
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
COPIAH COUNTY MEDICAL CENTER
Practice address
27190 Highway 28
Hazlehurst, MS 39083-2224
Phone
(601) 574-7000
Fax
(601) 574-7216
NPI assigned
Feb 19, 2014
Last updated
Sep 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Authorized official

Name
Kortney Gaddy, MBA, CPA
Title
Chief Financial Officer
Phone
(601) 574-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

27190 Highway 28
Hazlehurst, MS 39083-2224

Mailing address

27190 Highway 28
Hazlehurst, MS 39083-2224
Phone (601) 574-7000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130211000504 MS Part B Supplier - Clinic/Group Practice 2062583487 Receives reassigned benefits from 92 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hazlehurst, MS

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Hardy Wilson Memorial Hospital7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

213 Caldwell Dr
Hazlehurst, MS 39083
Phone (601) 892-2225

1096 Beech St
Wesson, MS 39191
Phone (601) 643-5878

Practitioners & affiliated clinicians

Practitioners 41

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 41

NPI Registry JSON

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

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1083039663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27190 HIGHWAY 28",
            "city": "HAZLEHURST",
            "state": "MS",
            "postal_code": "390832224",
            "telephone_number": "601-574-7000",
            "fax_number": "601-574-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27190 HIGHWAY 28",
            "city": "HAZLEHURST",
            "state": "MS",
            "postal_code": "390832224",
            "telephone_number": "601-574-7000",
            "fax_number": "601-574-7216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPIAH COUNTY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-19",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "GADDY",
        "authorized_official_first_name": "KORTNEY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "601-574-7000",
        "authorized_official_credential": "MBA, CPA"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazlehurst, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.