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Organization Active NPI

Baptist Memorial Hospital-Tipton

  • General Acute Care Hospital
  • Covington, TN
National Provider Identifier
1316901937
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
00000117 Issued in TN
Legal business name
BAPTIST MEMORIAL HOSPITAL-TIPTON
Practice address
1995 Highway 51 S
Covington, TN 38019-3635
Phone
(901) 476-2621
NPI assigned
Apr 12, 2006
Organization subpart
Yes
Parent organization
BAPTIST MEMORIAL HEALTH CARE CORP.As reported in NPPES

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
Gregory M Duckett
Title
Sr VP/ Clo
Phone
(901) 227-5233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 00000117 TN Primary

Addresses

Primary practice location

1995 Highway 51 S
Covington, TN 38019-3635

Mailing address

350 N Humphreys Blvd
Memphis, TN 38120-2177

Other identifiers 2

IdentifierTypeStateIssuer
0440131MedicaidTN
0009542OtherTNBLUE CROSS PROVIDER NUMB

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040331001497 TN Part B Supplier - Clinic/Group Practice 6709878614 Receives reassigned benefits from 57 practitioners
Practice locations: Memphis, TN; Union City, TN; Dyersburg, TN; Covington, TN; Collierville, TN; Bartlett, TN
O20091001000242 TN Part A Provider - Hospital 6709878614 Practice locations: Memphis, TN; Union City, TN; Germantown, TN; Covington, TN; Dyersburg, TN; Bartlett, TN; Atoka, TN; Collierville, TN

Hospital certification: CCN 440131

Legal name
BAPTIST MEMORIAL HOSPITAL-TIPTON
Doing business as
BMH - TIPTON
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 12, 1966
Last certification
Aug 18, 1993
Beds
100
Ownership / control type
Church
Organization structure
CorporationNon-profit
Incorporated
Oct 15, 1980 in TN
Enrollment address
1995 Highway 51 S
Covington, TN 38019-3635
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

National Provider Directory

National Provider Directory
Tax ID family
Baptist Memorial Hospital-Tipton5 organizations share this tax ID, including this one
Part of
Baptist Memorial Health Care Corp

Other organizations with this tax ID 4

Organizations that report the same tax identification number in 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
Jason M Little Individual Corporate OfficerPresident Aug 1, 2011
Corporate DirectorOfficer President Aug 1, 2011
Cary M. Finn Individual Corporate DirectorBoard Member Aug 20, 2020
Parker Harris Individual W-2 Managing EmployeeCeo Aug 20, 2020
Gary C Anderson Individual Corporate OfficerOfficer SVP Jan 1, 2024
Arthur Maples Individual Corporate DirectorDirector Dec 1, 2015
Paul Cade Individual Corporate OfficerBoard Member Jan 1, 2024
Kris Azlin Individual Corporate DirectorBoard Member Jan 1, 2024
Arie Szatkowski Individual Corporate DirectorBoard Member Aug 20, 2020
Gregory M Duckett Individual Corporate OfficerCorp Sec Jan 1, 2000
Dale L Morris Individual Corporate DirectorChair Dec 1, 2015
Riad I Homsi Individual Corporate DirectorBoard Member Aug 20, 2020
Baptist Memorial Health Care Corporation Organization, Memphis, TN Corporation 5% Or Greater Indirect Ownership Interest Oct 15, 1980

Owners & managing parties with NPI records 3

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

Facilities with the same owner 47

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

View all 47

Practitioners 80

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

View all 80

Affiliated clinicians 379

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

View all 379

Care Compare: Hospital

Medicare Care Compare
Listed as
Baptist Memorial Hospital TiptonCCN 440131
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601424000000",
    "number": "1316901937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N HUMPHREYS BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 HIGHWAY 51 S",
            "city": "COVINGTON",
            "state": "TN",
            "postal_code": "380193635",
            "telephone_number": "901-476-2621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST MEMORIAL HOSPITAL-TIPTON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAPTIST MEMORIAL HEALTH CARE CORP.",
        "enumeration_date": "2006-04-12",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A",
        "authorized_official_last_name": "DUCKETT",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SR VP/ CLO",
        "authorized_official_telephone_number": "901-227-5233"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TN",
            "license": "00000117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0440131",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMB",
            "identifier": "0009542",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, TN

Sources for this page

Verify at the official NPI Registry.