NPIMap

Organization Active NPI

Tippah County Hospital

Doing business as Tippah County Health Services1

  • General Acute Care Hospital
  • Ripley, MS
National Provider Identifier
1306882246
Registry record updated Nov 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
11-159 Issued in MS
Legal business name
TIPPAH COUNTY HOSPITAL
Doing business as
Tippah County Health Services1
Practice address
1005 City Ave N
1005 City Avenue North
Ripley, MS 38663-1414
Phone
(662) 837-9221
Fax
(662) 837-2110
NPI assigned
Jun 21, 2006
Last updated
Nov 30, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2012

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

Authorized official

Name
Craig Cudsworth
Title
Ceo
Phone
(662) 837-9221

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 11-159 MS Primary

Addresses

Primary practice location

1005 City Ave N
1005 City Avenue North
Ripley, MS 38663-1414

Mailing address

PO Box 499
Ripley, MS 38663-0499
Phone (662) 837-9221

Other identifiers 2

IdentifierTypeStateIssuer
000020111OtherMSBLUE CROSS
00020111MedicaidMS

Other names 1

  • Tippah County Health Services1 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140811000295 MS Part A Provider - Critical Access Hospital 5193746709 Receives reassigned benefits from 30 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ripley, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306882246. Details of each certification follow.

Hospital certification: CCN 251337

Legal name
TIPPAH COUNTY HOSPITAL
Doing business as
TIPPAH COUNTY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jan 1, 2015
Last certification
Dec 16, 2022
Beds
45 (25 certified)
Ownership / control type
Local
Organization structure
OtherNon-profit
Incorporated
in MS
Enrollment address
1005 City Avenue North
Tippah County Health Services
Ripley, MS 38663-1414
Other Hospital Practice Location

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Tippah County HospitalCCN 251337 · All quality measures
Overall star rating
4 of 5
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member of 1

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

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
David D Hubbard Individual Corporate DirectorBoard Member Jun 3, 2013 14.29%
Ray Crawford Individual Corporate DirectorBoard Member Feb 4, 2008 14.29%
Lana Richardson Individual Corporate DirectorBoard Member Nov 15, 2007 14.29%
Roger Childs Individual Corporate DirectorBoard Member Apr 7, 2008 14.29%
Vickie Johnson Skinner Individual Corporate DirectorBoard Member Dec 3, 2007 14.29%
Greg Ward Individual Corporate DirectorBord Member Jan 1, 2015 14.29%
Patrick Chapman Individual Corporate DirectorBoard Member Sep 8, 2010 14.29%
Tippah County, Mississippi Organization, Ripley, MS 5% Or Greater Direct Ownership Interest Oct 1, 2014 100%
Jessica Collins Individual W-2 Managing Employee Dec 9, 2016
Tabitha Clifton Individual W-2 Managing EmployeeN/a Dec 9, 2019
Robert Cagle Individual Corporate DirectorBoard Member Apr 15, 2015 14.29%
Mark M Richey Individual Contracted Managing EmployeeInterim Administrator/Cfo Jul 18, 2014 100%
Corporate OfficerInterim Administrator/Cfo Jul 18, 2014 100%

Practitioners & affiliated clinicians

Practitioners 11

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.

Affiliated clinicians 69

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 69

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354233600000",
    "number": "1306882246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 499",
            "city": "RIPLEY",
            "state": "MS",
            "postal_code": "386630499",
            "telephone_number": "662-837-9221",
            "fax_number": "662-837-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 CITY AVE N",
            "address_2": "1005 CITY AVENUE NORTH",
            "city": "RIPLEY",
            "state": "MS",
            "postal_code": "386631414",
            "telephone_number": "662-837-9221",
            "fax_number": "662-837-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIPPAH COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2012-11-30",
        "status": "A",
        "authorized_official_last_name": "CUDSWORTH",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-837-9221"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MS",
            "license": "11-159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000020111",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00020111",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tippah County Health Services1",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ripley, MS

Sources for this page

Verify at the official NPI Registry.