NPIMap

Organization Active NPI

Alliance Healthcare System, Inc

  • General Acute Care Hospital
  • Holly Springs, MS
National Provider Identifier
1295826337
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
16-252 Issued in MS
Legal business name
ALLIANCE HEALTHCARE SYSTEM, INC
Practice address
1430 Hwy 4-East
Holly Springs, MS 38634
Phone
(662) 551-3369
Fax
(662) 551-3421
NPI assigned
Sep 27, 2006
Organization subpart
Yes
Parent organization
ALLIANCE HEALTHCARE SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Authorized official

Name
Perry E. Williams Sr.
Title
Administrator
Phone
(662) 252-1212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 16-252 MS Primary

Addresses

Primary practice location

1430 Hwy 4-East
Holly Springs, MS 38634

Mailing address

PO Box 6000
Holly Springs, MS 38634-6000
Phone (662) 551-3369

Other identifiers 1

IdentifierTypeStateIssuer
00220621MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240524001676 MS Part A Provider - Hospital 2961489547 Practice locations: Holly Springs, MS

Hospital certification: CCN 250174

Legal name
ALLIANCE HEALTHCARE SYSTEM, INC
Doing business as
PROGRESSIVE HEALTH OF HOLLY SPRINGS
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Oct 15, 2024
Last certification
Aug 14, 2024
Beds
10
Ownership / control type
Private (for profit)
Organization structure
CorporationProprietary
Incorporated
Feb 1, 1989 in MS
Enrollment address
1430 Highway 4 E
Holly Springs, MS 38635-2140
Main/Primary Hospital Location
Hospital subgroups
Acute care, Swing-bed approved, Psychiatric unit

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

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Alliance Healthcare System, IncCCN 250174
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Part of
Marshall Med CT Marshal

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

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
Regina Williams Individual Corporate Director Nov 1, 1999
Kenneth Williams Individual 5% Or Greater Direct Ownership Interest Nov 1, 1999 100%
W-2 Managing EmployeeCeo Nov 1, 1999 100%
Ethel Thompson Individual Corporate Director Nov 1, 1999

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 6

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

Affiliated clinicians 8

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": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1295826337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6000",
            "city": "HOLLY SPRINGS",
            "state": "MS",
            "postal_code": "386346000",
            "telephone_number": "662-551-3369",
            "fax_number": "662-551-3421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 HWY 4-EAST",
            "city": "HOLLY SPRINGS",
            "state": "MS",
            "postal_code": "38634",
            "telephone_number": "662-551-3369",
            "fax_number": "662-551-3421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE HEALTHCARE SYSTEM, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALLIANCE HEALTHCARE SYSTEM",
        "enumeration_date": "2006-09-27",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "PERRY",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "662-252-1212",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MS",
            "license": "16-252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00220621",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly Springs, MS

Sources for this page

Verify at the official NPI Registry.