NPIMap

Organization Active NPI

Monroe Health Services, Inc.

Doing business as North Mississippi Medical Center - Gilmore - Amory

  • Medicare Defined Swing Bed Hospital Unit
  • Amory, MS
National Provider Identifier
1245701531
Registry record updated Dec 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
MONROE HEALTH SERVICES, INC.
Doing business as
North Mississippi Medical Center - Gilmore - Amory
Practice address
1105 Earl Frye Blvd.
Amory, MS 38821-5500
Phone
(662) 256-7111
Fax
(662) 256-6007
NPI assigned
Dec 11, 2018
Last updated
Dec 11, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
MONROE HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 11, 2018

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

Authorized official

Name
Mr. Bruce J. Toppin
Title
Corporate Secretary
Phone
(662) 377-4229

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

Addresses

Primary practice location

1105 Earl Frye Blvd.
Amory, MS 38821-5500

Mailing address

830 South Gloster Street
Tupelo, MS 38801
Phone (662) 377-4229

Other names 1

  • North Mississippi Medical Center - Gilmore - Amory Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190215000121 MS Part A Provider - Hospital 8224376561 Practice locations: Amory, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245701531. Details of each certification follow.

Hospital certification: CCN 25U025

Legal name
MONROE HEALTH SERVICES INC
Doing business as
NORTH MISSISSIPPI MEDICAL CENTER-GILMORE-AMORY
Organization structure
CorporationNon-profit
Incorporated
Oct 10, 2018 in DE
Enrollment address
1105 Earl Frye Blvd
Amory, MS 38821-5500
Hospital Swing-Bed Unit
Hospital subgroups
Swing-bed approved

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

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Monroe Health Services Inc9 organizations share this tax ID, including this one
Part of
Monroe Health Services Inc

Other organizations with this tax ID 8

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

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
James Allen Tyra Individual Corporate OfficerCeo/Administrator Jan 1, 2019
W-2 Managing EmployeeCeo/Administrator Jan 1, 2019
North Mississippi Health Services Inc Organization, Tupelo, MS Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2019 100%
Bruce J Toppin Individual Corporate OfficerSecretary Jan 1, 2019
Corporate DirectorDirector Jan 1, 2019
Sharon D Nobles Individual Corporate OfficerTreasurer Jan 1, 2019
Corporate DirectorDirector Jan 1, 2019
Michael S Spees Individual Corporate OfficerPresident Jan 1, 2019
Corporate DirectorDirector Jan 1, 2019

Facilities with the same owner 33

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

View all 33

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1544486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544486400000",
    "number": "1245701531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 SOUTH GLOSTER STREET",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "38801",
            "telephone_number": "662-377-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 EARL FRYE BLVD.",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "388215500",
            "telephone_number": "662-256-7111",
            "fax_number": "662-256-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONROE HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MONROE HEALTH SERVICES, INC.",
        "enumeration_date": "2018-12-11",
        "last_updated": "2018-12-11",
        "status": "A",
        "authorized_official_last_name": "TOPPIN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CORPORATE SECRETARY",
        "authorized_official_telephone_number": "662-377-4229",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Mississippi Medical Center - Gilmore - Amory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Amory, MS

Sources for this page

Verify at the official NPI Registry.