NPIMap

Organization Active NPI

Anderson Regional Medical Center

Doing business as Baptist Anderson Tom C. Maynor Rehabilitation Center

  • Rehabilitation Hospital Unit
  • Meridian, MS
National Provider Identifier
1114223880
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
12249 Issued in MS
Legal business name
ANDERSON REGIONAL MEDICAL CENTER
Doing business as
Baptist Anderson Tom C. Maynor Rehabilitation Center
Practice address
1102 Constitution Ave
Meridian, MS 39301-4001
Phone
(601) 693-2511
Fax
(601) 484-3130
NPI assigned
Jan 28, 2011
Last updated
Aug 16, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ANDERSON REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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
Rehabilitation Hospital Unit 273Y00000X 12249 MS Primary

Addresses

Primary practice location

1102 Constitution Ave
Meridian, MS 39301-4001

Mailing address

2124 14TH St
Meridian, MS 39301-4040
Phone (601) 553-6000

Other names 1

  • Baptist Anderson Tom C. Maynor Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110322000726 MS Part A Provider - Hospital 4284548025 Practice locations: Meridian, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114223880. Details of each certification follow.

Hospital certification: CCN 25T081

Legal name
ANDERSON REGIONAL MEDICAL CENTER
Doing business as
BAPTIST ANDERSON TOM C. MAYNOR REHABILITATION CENTER
Organization structure
CorporationNon-profit
Enrollment address
1102 Constitution Ave
Meridian, MS 39301-4001
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

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

Other NPIs with the same Medicare PAC ID 10

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Anderson Medical CenterCCN 25T081 · All quality measures
Ownership
For profit
Certified
Jan 1, 2000

National Provider Directory

National Provider Directory
Tax ID family
Stonewall Fam Med Ctr19 organizations share this tax ID, including this one
Part of
Stonewall Fam Med Ctr

Other organizations with this tax ID 18

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

View all 18

Ownership & related parties

All disclosed owners & managing parties 13

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 Bmhcc Jan 1, 2024
Operational/Managerial ControlPresident / Ceo Jan 1, 2024
James Grantham Individual Corporate DirectorMember of the Board Jan 1, 2024
Operational/Managerial ControlMember of the Board Jan 1, 2024
Wilbur G Wilkinson Individual Corporate OfficerVice Chairman of the Board Jan 1, 2024
Corporate DirectorMember of the Board Jan 1, 2024
Operational/Managerial ControlMember of the Board Jan 1, 2024
Joseph M Anderson Individual Corporate OfficerChairman of the Board Jan 1, 2024
Corporate Director Jan 1, 2011
Operational/Managerial ControlChairman of the Board Jan 1, 2024
David Vowell Individual Corporate DirectorMember of the Board Jan 1, 2011
Operational/Managerial ControlMember of the Board Jan 1, 2024
John G Anderson Individual Corporate Officer Jul 28, 2011
W-2 Managing Employee Jul 28, 2011
Arthur Maples Individual W-2 Managing EmployeeDir. Reg. Planning/Policy @ P Jan 1, 2024
Janet G Farrington Individual Corporate DirectorMember of the Board Jan 1, 2011
Operational/Managerial ControlMember of the Board Jan 1, 2024
Anderson Regional Medical Center Organization, Meridian, MS Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
Gregory M Duckett Individual Corporate OfficerSecretary Jan 1, 2024
Corporate DirectorMember of the Board Jan 1, 2024
Operational/Managerial ControlMember of the Board Jan 1, 2024
Baptist Memorial Health Care Corporation Organization, Memphis, TN Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Jan 1, 2024 100%
Operational/Managerial Control Jan 1, 2024 100%
Shawn Shawn Anderson Individual Corporate DirectorMember of the Board Jan 1, 2011
Operational/Managerial ControlMember of the Board Jan 1, 2024
Brad Huff Individual Corporate Director Mar 1, 2020
Operational/Managerial ControlMember of the Board Jan 1, 2024

Owners & managing parties with NPI records 11

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 7

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

FacilityTypeRoleSince
Anderson Regional Medical CenterMeridian, MS, CCN 250104 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 1966
Jan 1, 2024
Baptist Anderson Regional Medical Center - SouthMeridian, MS, CCN 250081 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Baptist Anderson Senior Behavioral Health CenterMeridian, MS, CCN 25S081 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2011
Jan 1, 2001
Baptist Anderson Swing Bed UnitMeridian, MS, CCN 25U081 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2011
Baptist Anderson Family Medical Center- EnterpriseEnterprise, MS, CCN 258588 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2011
Jan 1, 2011
Baptist Anderson Children's Medical CenterMeridian, MS, CCN 258584 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2011
Baptist Anderson Family Medical Center- AirparkPhiladelphia, MS, CCN 258587 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2011

Owned or controlled facilities with NPI records 7

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 1

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.

Affiliated clinicians 10

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

NPI Registry JSON

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

{
    "created_epoch": "1296172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1114223880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 14TH ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014040",
            "telephone_number": "601-553-6000",
            "fax_number": "601-553-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 CONSTITUTION AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014001",
            "telephone_number": "601-693-2511",
            "fax_number": "601-484-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANDERSON REGIONAL MEDICAL CENTER",
        "enumeration_date": "2011-01-28",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "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": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "MS",
            "license": "12249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Anderson Tom C. Maynor Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.