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Organization Active NPI

Wayne General Hospital

Doing business as Wayne General Crna

  • Certified Registered Nurse Anesthetist
  • Waynesboro, MS
National Provider Identifier
1093930638
Registry record updated May 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
11-288 Issued in MS
Legal business name
WAYNE GENERAL HOSPITAL
Doing business as
Wayne General Crna
Practice address
950 Matthew Dr
Waynesboro, MS 39367-2567
Phone
(601) 735-5151
Fax
(601) 735-7168
NPI assigned
Apr 17, 2007
Last updated
May 18, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
WAYNE GENERAL HOSPTIALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 18, 2015

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

Authorized official

Name
Mrs. Kathy Waddell
Title
Administrator
Phone
(601) 735-5151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 11-288 MS Primary

Addresses

Primary practice location

950 Matthew Dr
Waynesboro, MS 39367-2567

Mailing address

950 Matthew Dr
P O Box 1249
Waynesboro, MS 39367-2567
Phone (601) 735-5151

Other identifiers 1

IdentifierTypeStateIssuer
09012424MedicaidMS

Other names 1

  • WAYNE GENERAL CRNA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040623000865 MS Part B Supplier - Clinic/Group Practice 2668457581 Receives reassigned benefits from 51 practitioners
7 other NPIs on this enrollment
Practice locations: Waynesboro, MS

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
Wayne General Hosp Gen14 organizations share this tax ID, including this one
Part of
Wayne General Hosp Gen

Other organizations with this tax ID 13

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

View all 13

Ownership & related parties

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Wayne General HospitalWaynesboro, MS, CCN 250077 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 May 21, 1967
May 21, 1967
Wayne General HospitalWaynesboro, MS, CCN 25U077 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Aug 8, 1989
Aug 8, 1989
Wayne General HospitalWaynesboro, MS, CCN 257088 Home health agency 5% Or Greater Direct Ownership Interest (100%) Oct 1, 1978
Wayne General HospitalWaynesboro, MS, CCN 258546 Rural health clinic 5% Or Greater Direct Ownership Interest Sep 2, 2008
Wayne General School ClinicWaynesboro, MS, CCN 258652 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2021

Owned or controlled facilities with NPI records 5

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

  • Wayne General Hospital

    dba Waynesboro Family Medicine & Obstetrics

    • Rural Health Clinic/Center
    • Waynesboro, MS
    • NPI 1285882662

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Wayne General Hospital

    dba Wayne General Swingbed

    • Medicare Defined Swing Bed Hospital Unit
    • Waynesboro, MS
    • NPI 1417978982

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

    CMS ownership
  • Wayne General Hospital

    dba Wayne General School Clinic

    • Rural Health Clinic/Center
    • Waynesboro, MS
    • NPI 1558963496

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Wayne General Hospital

    dba Wayne General Home Health

    • Home Health Agency
    • Waynesboro, MS
    • NPI 1598787160

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Wayne General Hospital
    • General Acute Care Hospital
    • Waynesboro, MS
    • NPI 1679559983

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

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 56

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 56

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431907200000",
    "number": "1093930638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 MATTHEW DR",
            "address_2": "P O BOX 1249",
            "city": "WAYNESBORO",
            "state": "MS",
            "postal_code": "393672567",
            "telephone_number": "601-735-5151",
            "fax_number": "601-735-7168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 MATTHEW DR",
            "city": "WAYNESBORO",
            "state": "MS",
            "postal_code": "393672567",
            "telephone_number": "601-735-5151",
            "fax_number": "601-735-7168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE GENERAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAYNE GENERAL HOSPTIAL",
        "enumeration_date": "2007-04-17",
        "last_updated": "2015-05-18",
        "status": "A",
        "authorized_official_last_name": "WADDELL",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "601-735-5151",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "11-288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09012424",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WAYNE GENERAL CRNA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waynesboro, MS

Sources for this page

Verify at the official NPI Registry.