NPIMap

Organization Active NPI

Delta Health System

  • Community Based Hospice Care Agency
  • Greenville, MS
National Provider Identifier
1295822575
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
041 Issued in MS
Legal business name
DELTA HEALTH SYSTEM
Practice address
1693 Fairgrounds Rd
Greenville, MS 38703-7810
Phone
(662) 725-1200
Fax
(663) 725-2309
NPI assigned
Oct 6, 2006
Organization subpart
Yes
Parent organization
DELTA HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Authorized official

Name
Ms. Iris Y. Stacker, RHIA
Title
Interim Ceo
Phone
(662) 725-2099

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 041 MS Primary

Addresses

Primary practice location

1693 Fairgrounds Rd
Greenville, MS 38703-7810

Mailing address

P.O. Box 5247
Greenville, MS 38704-5247
Phone (662) 725-1200

Other identifiers 1

IdentifierTypeStateIssuer
00770183MedicaidMS

Other names 2

  • Delta Health-The Medical Center Doing business as
  • Delta Health-The Medical Center (Hospice) Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071213000351 MS Part A Provider - Hospice 0042208787 Practice locations: Greenville, MS

Hospice certification: CCN 251538

Legal name
DELTA HEALTH SYSTEM
Doing business as
DELTA HEALTH - THE MEDICAL CENTER (HOSPICE)
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 2, 1997
Last certification
Dec 5, 2019
Ownership / control type
Government - County
Organization structure
GovernmentNon-profit
Incorporated
Oct 1, 1968 in MS
Enrollment address
1693 Fairgrounds Rd
Greenville, MS 38703-1693

Other NPIs with the same Medicare PAC ID 6

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Delta Health- the Medical Center (Hospice)CCN 251538
Ownership
Government
Certified
Apr 2, 1997
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Delta Regional Medical Center Ambulance Service9 organizations share this tax ID, including this one
Part of
Delta Regional Medical Center Ambulance Service

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 4

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

NameRoleSinceShare
Delta Health System Organization, Greenvilee, MS Non-profit 5% Or Greater Direct Ownership Interest Nov 24, 1975
Henry Rucker Individual Corporate Director Oct 1, 2001
Monty Beasley Individual Corporate OfficerCfo Oct 23, 2025
W-2 Managing EmployeeAd; Oct 23, 2025
Iris Y Stacker Individual Corporate OfficerCeo Jul 13, 2022

Owners & managing parties with NPI records 6

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Delta Health-the Medical Center (Ip Rehab)Greenville, MS, CCN 25T082 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 1, 1984
Delta Health-the Medical CenterGreenville, MS, CCN 257098 Home health agency 5% Or Greater Direct Ownership Interest Nov 24, 1975
Delta Health SystemGreenville, MS, CCN 253461 Rural health clinic Operational/Managerial Control (100%) Jun 10, 1996

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

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": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665964800000",
    "number": "1295822575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 5247",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387045247",
            "telephone_number": "662-725-1200",
            "fax_number": "662-725-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1693 FAIRGROUNDS RD",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387037810",
            "telephone_number": "662-725-1200",
            "fax_number": "663-725-2309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA HEALTH SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DELTA HEALTH SYSTEM",
        "enumeration_date": "2006-10-06",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A",
        "authorized_official_last_name": "STACKER",
        "authorized_official_first_name": "IRIS",
        "authorized_official_middle_name": "Y.",
        "authorized_official_title_or_position": "INTERIM CEO",
        "authorized_official_telephone_number": "662-725-2099",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RHIA"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MS",
            "license": "041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00770183",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Delta Health-The Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Delta Health-The Medical Center (Hospice)",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Greenville, MS

Sources for this page

Verify at the official NPI Registry.