NPIMap

Organization Active NPI

Jasper General Hospital

  • Rural Health Clinic/Center
  • Bay Springs, MS
National Provider Identifier
1245870823
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
JASPER GENERAL HOSPITAL
Practice address
27 S Sixth St
Bay Springs, MS 39422-9052
Phone
(601) 764-2155
Fax
(601) 764-2150
NPI assigned
Jan 10, 2020
Organization subpart
No

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
Griff M Kelly
Title
Cfo
Phone
(601) 764-2101

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

27 S Sixth St
Bay Springs, MS 39422-9052

Mailing address

PO Box 527
Bay Springs, MS 39422-0527

Other names 1

  • Jasper County After Hours Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130115000077 MS Part B Supplier - Clinic/Group Practice 1052487105 Receives reassigned benefits from 13 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bay Springs, MS
O20200313000250 MS Part A Provider - Rural Health Clinic 1052487105 Practice locations: Bay Springs, MS

Rural health clinic certification: CCN 258643

Legal name
JASPER GENERAL HOSPITAL
Doing business as
JASPER COUNTY AFTER HOURS CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 20, 2020
Last certification
Jun 20, 2023
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Incorporated
Nov 28, 1961 in MS
Enrollment address
27 S Sixth St
Bay Springs, MS 39422-9052
Related CCNs
250018

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).

Other NPIs on the same Medicare enrollment 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D0707889Jasper County After Hours Clinic27 South 6TH Street, Bay Springs, MS 39422Certificate of waiverAug 5, 2026

National Provider Directory

National Provider Directory
Tax ID family
Jasper General Hospital7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

15 S Sixth St
#A
Bay Springs, MS 39422
Phone (601) 764-2101

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Jasper General Hospital Organization, Bay Springs, MS 5% Or Greater Direct Ownership Interest Jan 1, 2020 100%
Griff Kelly Individual Corporate OfficerCfo Jan 1, 2020 100%
W-2 Managing EmployeeCfo Jan 1, 2020 100%
Jacqueline Barnes Individual W-2 Managing EmployeeMedical Records Director Aug 12, 2025 5%

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Pro Care Home HealthBay Springs, MS, CCN 257096 Home health agency 5% Or Greater Direct Ownership Interest (100%) Dec 1, 1975

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601424000000",
    "number": "1245870823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 527",
            "city": "BAY SPRINGS",
            "state": "MS",
            "postal_code": "394220527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 S SIXTH ST",
            "city": "BAY SPRINGS",
            "state": "MS",
            "postal_code": "394229052",
            "telephone_number": "601-764-2155",
            "fax_number": "601-764-2150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASPER GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-10",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "GRIFF",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "601-764-2101"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jasper County After Hours Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jasper County After Hours Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bay Springs, MS

Sources for this page

Verify at the official NPI Registry.