NPIMap

Organization Active NPI

Covington County Hospital

  • Psychiatric Hospital Unit
  • Collins, MS
National Provider Identifier
1225150436
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
COVINGTON COUNTY HOSPITAL
Practice address
701 S Holly Ave
Collins, MS 39428-3894
Phone
(601) 765-6711
Fax
(601) 698-0180
NPI assigned
Apr 6, 2007
Last updated
Jun 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Authorized official

Name
Gregg Gibbes
Title
Ceo
Phone
(601) 698-0101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X Primary

Addresses

Primary practice location

701 S Holly Ave
Collins, MS 39428-3894

Mailing address

PO Box 1149
Collins, MS 39428-1149
Phone (601) 765-6711

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080912000376 MS Part A Provider - Critical Access Hospital 4183517253 Receives reassigned benefits from 2 practitioners
Practice locations: Collins, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225150436. Details of each certification follow.

Hospital certification: CCN 25M325

Legal name
COVINGTON COUNTY HOSPITAL
Organization structure
GovernmentNon-profit
Incorporated
Jul 1, 1951 in MS
Enrollment address
701 S Holly Ave
Collins, MS 39428-3894
Hospital Psychiatric Unit

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

Other NPIs with the same Medicare PAC ID 15

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

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Covington County Hospital15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
James McPhail Individual Corporate DirectorBoard Member Jan 15, 2009 100%
Covington County Hospital Organization, Collins, MS 5% Or Greater Direct Ownership Interest Jan 1, 2016
Robert Johnson Individual Corporate DirectorBoard President Nov 23, 2007 100%
Greg Sullivan Individual Corporate DirectorBoard Member Oct 8, 2007 100%
Gregg Gibbes Individual Corporate OfficerCeo Apr 28, 2016 100%
W-2 Managing EmployeeCeo Apr 28, 2016 100%
Operational/Managerial ControlCeo Apr 28, 2016 100%
Everlean Booth Individual Corporate DirectorBoard Member-Secretary Nov 18, 2005 100%

Owners & managing parties with NPI records 15

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

View all 15

All facility ownership & control disclosures 7

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

FacilityTypeRoleSince
Arrington Living CenterCollins, MS, CCN 255331 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 May 1, 2011
May 1, 2011
Family Medical AssociatesCollins, MS, CCN 253497 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2016
Family Care ExpressCollins, MS, CCN 258562 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2016
Jan 1, 2016
CCH Clinic MageeMagee, MS, CCN 258597 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Mar 1, 2018
Mar 1, 2018
Express Care SumrallSumrall, MS, CCN 258644 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2020
Family Care of MageeMagee, MS, CCN 258662 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 4, 2021
Jan 4, 2021
Family Care Magee Tuscan TowersMagee, MS, CCN 258660 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Sep 1, 2021
Sep 1, 2021

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 7

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

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": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654214400000",
    "number": "1225150436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1149",
            "city": "COLLINS",
            "state": "MS",
            "postal_code": "394281149",
            "telephone_number": "601-765-6711",
            "fax_number": "601-698-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S HOLLY AVE",
            "city": "COLLINS",
            "state": "MS",
            "postal_code": "394283894",
            "telephone_number": "601-765-6711",
            "fax_number": "601-698-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVINGTON COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A",
        "authorized_official_last_name": "GIBBES",
        "authorized_official_first_name": "GREGG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-698-0101"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collins, MS

Sources for this page

Verify at the official NPI Registry.