NPIMap

Organization Active NPI

Baptist Memorial Hospital- Union City Inc

  • General Acute Care Hospital
  • Union City, TN
National Provider Identifier
1114981768
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
00000091 Issued in TN
Legal business name
BAPTIST MEMORIAL HOSPITAL- UNION CITY INC
Practice address
1201 Bishop St
Union City, TN 38261-5403
Phone
(731) 884-8601
NPI assigned
Apr 12, 2006
Last updated
Sep 30, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
BAPTIST MEMORIAL HEALTH CARE CORP.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Authorized official

Name
Gregory Duckett
Title
Sr VP/ Clo
Phone
(901) 227-5233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 00000091 TN Primary

Addresses

Primary practice location

1201 Bishop St
Union City, TN 38261-5403

Mailing address

350 N Humphreys Blvd
Memphis, TN 38120-2177
Phone (731) 884-8601

Other identifiers 5

IdentifierTypeStateIssuer
044130MedicaidTN
1000403OtherTNBLUE CROSS PROVIDER NUMB
0066791OtherTNBLUE CROSS PROVIDER NUMB
2097OtherTNTNCARE PROVIDER NUMBER
01620285MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031203000217 TN Part B Supplier - Clinic/Group Practice 4385549427 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Union City, TN
O20090930000275 TN Part A Provider - Hospital 4385549427 Practice locations: Union City, TN
O20190318001111 TN Part B Supplier - Intensive Cardiac Rehabilitation 4385549427 Practice locations: Union City, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114981768. Details of each certification follow.

Hospital certification: CCN 440130

Legal name
BAPTIST MEMORIAL HOSPITAL- UNION CITY INC.
Doing business as
BMH-UNION CITY
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Aug 29, 2012
Beds
137
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Mar 10, 1982 in TN
Enrollment address
1201 Bishop Street
Union City, TN 38261-5403
Other Hospital Practice Location
Hospital subgroups
General, Acute care, Psychiatric, Short-term, Psychiatric unit

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 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Baptist Memorial Hospital Union CityCCN 440130 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
Baptist Memorial Health Care Corp

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 OfficerCorporate Vice President Nov 1, 2007
Arthur Maples Individual Corporate OfficerDelegated Official Dec 1, 2015
Corporate DirectorDirector Dec 1, 2015
Baptist Memorial Hospital- Union City Inc. Organization, Union City, TN Non-profit 5% Or Greater Indirect Ownership Interest Mar 10, 1982
Mary Carpenter Individual Corporate DirectorBoard Member Jan 1, 2009
Paul Duane Depriest Individual Corporate Officer Jun 1, 2014
Terry L Roberson Individual Corporate DirectorBoard Member Jan 1, 2014
James M Glasgow Individual Corporate DirectorBoard Member Jan 1, 2009
Gregory M Duckett Individual Corporate OfficerCorporate Secretary/Treasurer Jan 1, 2000
Gary Houston Individual Corporate DirectorBoard Member Feb 17, 2011
Barry Bondurant Individual W-2 Managing EmployeeCeo/Administrator Jun 4, 2012
Chuck Doss Individual Corporate DirectorBoard Member Jan 1, 2014
William Griffin Individual Corporate Officer Dec 1, 2015
Baptist Memorial Health Care Corporation Organization, Memphis, TN Non-profit 5% Or Greater Direct Ownership Interest Mar 10, 1982
Other Mar 10, 1982

Owners & managing parties with NPI records 2

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

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 21

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 21

Affiliated clinicians 228

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

View all 228

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601424000000",
    "number": "1114981768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N HUMPHREYS BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202177",
            "telephone_number": "731-884-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 BISHOP ST",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615403",
            "telephone_number": "731-884-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST MEMORIAL HOSPITAL- UNION CITY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAPTIST MEMORIAL HEALTH CARE CORP.",
        "enumeration_date": "2006-04-12",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A",
        "authorized_official_last_name": "DUCKETT",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "SR VP/ CLO",
        "authorized_official_telephone_number": "901-227-5233"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TN",
            "license": "00000091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044130",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMB",
            "identifier": "1000403",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMB",
            "identifier": "0066791",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TNCARE PROVIDER NUMBER",
            "identifier": "2097",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01620285",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, TN

Sources for this page

Verify at the official NPI Registry.