NPIMap

Organization Active NPI

Anderson Regional Medical Center

  • Rural Health Clinic/Center
  • Enterprise, MS
National Provider Identifier
1356780423
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ANDERSON REGIONAL MEDICAL CENTER
Practice address
83A Old Mill Creek Rd
Enterprise, MS 39330-9649
Phone
(601) 704-1020
Fax
(601) 704-1021
NPI assigned
Jun 21, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

83A Old Mill Creek Rd
Enterprise, MS 39330-9649

Mailing address

2124 14TH St
Meridian, MS 39301-4040
Phone (601) 703-3480

Other identifiers 1

IdentifierTypeStateIssuer
04276719MedicaidMS

Other names 1

  • Baptist Anderson Family Medical Center-Enterprise Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130823000566 MS Part A Provider - Rural Health Clinic 4284548025 Practice locations: Enterprise, MS

Rural health clinic certification: CCN 258588

Legal name
ANDERSON REGIONAL MEDICAL CENTER
Doing business as
BAPTIST ANDERSON FAMILY MEDICAL CENTER- ENTERPRISE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 26, 2013
Last certification
Sep 1, 2022
Ownership / control type
2A
Organization structure
CorporationNon-profit
Enrollment address
83A Old Mill Creek Rd
Enterprise, MS 39330-9649
Related CCNs
250081

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

Other NPIs with the same Medicare PAC ID 10

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

National Provider Directory

National Provider Directory
Tax ID family
Stonewall Family Medica19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Ownership & related parties

All disclosed owners & managing parties 14

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 Bmhcc Jan 1, 2024
Operational/Managerial ControlPresident / Ceo Jan 1, 2024
James Grantham Individual Corporate DirectorBoard Member Jan 1, 2024
Operational/Managerial ControlBoard Member Jan 1, 2024
Wilbur G Wilkinson Individual Corporate OfficerVice Chairman of the Board Jan 1, 2024
Corporate DirectorVice Chairman of the Board Jan 1, 2024
Operational/Managerial ControlVice Chairman of the Board Jan 1, 2024
Joseph M Anderson Individual Corporate OfficerChairman of the Board Jan 1, 2011
Corporate DirectorBoard Member Jan 1, 2011
Operational/Managerial ControlChairman of the Board Jan 1, 2011
David Vowell Individual Corporate DirectorBoard Member Feb 1, 2014
Operational/Managerial ControlBoard Member Jan 1, 2024
John G Anderson Individual Corporate OfficerAdministrator Jul 28, 2011
Corporate DirectorAdministrator Jan 1, 2024
Operational/Managerial ControlAdministrator Jan 1, 2024
Arthur Maples Individual W-2 Managing EmployeeDir. Reg. Planning/ Policy @ Jan 1, 2024
Janet G Farrington Individual Corporate DirectorBoard Member Jan 1, 2011
Operational/Managerial ControlBoard Member Jan 1, 2024
Anderson Regional Medical Center Organization, Meridian, MS Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2011 100%
Operational/Managerial Control Jan 1, 2011 100%
Gregory M Duckett Individual Corporate OfficerSecretary Jan 1, 2024
Corporate DirectorBoard Member Jan 1, 2024
Operational/Managerial ControlBoard Member Jan 1, 2024
Kimberly Young Individual Corporate DirectorCorporate Officer Jan 1, 2024
Baptist Memorial Health Care Corporation Organization, Memphis, TN Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Jan 1, 2024 100%
Operational/Managerial Control Jan 1, 2024 100%
Shawn Shawn Anderson Individual Corporate DirectorBoard Member Jan 1, 2011
Operational/Managerial ControlBoard Member Jan 1, 2024
Brad Huff Individual Corporate DirectorBoard Member Mar 1, 2020
Operational/Managerial ControlBoard Member Jan 1, 2024

Owners & managing parties with NPI records 11

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

All facility ownership & control disclosures 7

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

FacilityTypeRoleSince
Anderson Regional Medical CenterMeridian, MS, CCN 250104 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 1966
Jan 1, 2024
Baptist Anderson Regional Medical Center - SouthMeridian, MS, CCN 250081 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Baptist Anderson Tom C. Maynor Rehabilitation CenterMeridian, MS, CCN 25T081 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Baptist Anderson Senior Behavioral Health CenterMeridian, MS, CCN 25S081 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2011
Jan 1, 2001
Baptist Anderson Swing Bed UnitMeridian, MS, CCN 25U081 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2011
Baptist Anderson Children'S Medical CenterMeridian, MS, CCN 258584 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2011
Baptist Anderson Family Medical Center- AirparkPhiladelphia, MS, CCN 258587 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2011

Owned or controlled facilities with NPI records 7

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

Facilities with the same owner 47

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

View all 47

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1371772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1356780423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 14TH ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014040",
            "telephone_number": "601-703-3480",
            "fax_number": "601-703-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83A OLD MILL CREEK RD",
            "city": "ENTERPRISE",
            "state": "MS",
            "postal_code": "393309649",
            "telephone_number": "601-704-1020",
            "fax_number": "601-704-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-21",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "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": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04276719",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Anderson Family Medical Center-Enterprise",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Enterprise, MS

Sources for this page

Verify at the official NPI Registry.