NPIMap

Organization Active NPI

State of Mississippi - University of Mississippi Medical Center

Doing business as Holmes County Hospital and Clinic

  • Critical Access Hospital
  • Lexington, MS
National Provider Identifier
1386630705
Registry record updated Dec 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Doing business as
Holmes County Hospital and Clinic
Practice address
239 Bowling Green Rd
Lexington, MS 39095-5167
Phone
(662) 834-1321
Fax
(601) 815-6301
NPI assigned
Sep 21, 2005
Last updated
Dec 12, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2018

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

Authorized official

Name
Mr. Jeffrey Grimsley
Title
Cfo
Phone
(601) 815-6270

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

239 Bowling Green Rd
Lexington, MS 39095-5167

Mailing address

2500 N State St
Jackson, MS 39216-4500
Phone (662) 834-1321

Other names 1

  • Holmes County Hospital and Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080702000327 MS Part A Provider - Critical Access Hospital 1850293036 Practice locations: Lexington, MS
O20090414000575 MS Part B Supplier - Clinic/Group Practice 1850293036 Receives reassigned benefits from 1,922 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386630705. Details of each certification follow.

Hospital certification: CCN 251319

Legal name
STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Doing business as
HOLMES COUNTY HOSPITAL & CLINICS
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 1, 2004
Last certification
Mar 25, 2014
Beds
25
Ownership / control type
State
Organization structure
GovernmentProprietary
Enrollment address
239 Bowling Green Road
Holmes County Hospital & Clinics
Lexington, MS 39095-5167
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 22

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

View all 22

Other NPIs on the same Medicare enrollment 15

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

View all 15

Care Compare: Hospital

Medicare Care Compare
Listed as
Holmes County Hospital and ClinicsCCN 251319 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - State
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Sigurds O Krolls MD62 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations (25 of 83)

1675 Cumberland Pkwy SE
Ste 103
Smyrna, GA 30080
Phone (770) 438-0202

203 W Peace St
Canton, MS 39046
Phone (601) 407-6104

6941 Highway 11
Ste A
Carriere, MS 39426
Phone (601) 749-3714

502 Broad St
Ste 2
Columbia, MS 39429
Phone (601) 736-8282

502 Broad St
Ste 3
Columbia, MS 39429
Phone (601) 736-8282

1 Lincoln Pkwy
Ste 102
Hattiesburg, MS 39402
Phone (601) 268-5830

1 Lincoln Pkwy
Ste 103
Hattiesburg, MS 39402
Phone (601) 261-1600

1 Medical Blvd
Hattiesburg, MS 39401
Phone (601) 268-9393

101 Courtenay Cir
Hattiesburg, MS 39402
Phone (601) 264-5684

102 Medical Park
Ste B
Hattiesburg, MS 39401
Phone (601) 261-1650

103 Medical Park
#1
Hattiesburg, MS 39401

103 Medical Park
Fl 2
Hattiesburg, MS 39401
Phone (601) 268-5630

103 Medical Park
Ste 1
Hattiesburg, MS 39401

1101 S 28th Ave
Hattiesburg, MS 39402
Phone (601) 296-2990

1101 S 28th Ave
#A
Hattiesburg, MS 39402
Phone (601) 261-1640

1101 S 28th Ave
Ste D
Hattiesburg, MS 39402
Phone (601) 296-2980

1185 Hart St
Hattiesburg, MS 39406

15 Professional Pkwy
Hattiesburg, MS 39402

1605 S 28th Ave
Hattiesburg, MS 39402
Phone (601) 264-5684

1606 S 28th Ave
Hattiesburg, MS 39402

27 Southern Point Pkwy
Hattiesburg, MS 39401
Phone (601) 288-2892

301 W Pine St
Hattiesburg, MS 39401
Phone (601) 544-0029

415 S 28th Ave
#1J
Hattiesburg, MS 39401

415 S 28th Ave
#2A
Hattiesburg, MS 39401

415 S 28th Ave
#2B
Hattiesburg, MS 39401

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Jeffrey G Grimsley Individual Corporate OfficerHealth System Cfo Sep 1, 2014
W-2 Managing EmployeeHealth System Cfo Sep 1, 2014
State of Mississippi-University of Mississippi Medical Center Organization, Jackson, MS 5% Or Greater Direct Ownership Interest Oct 1, 2004

Owners & managing parties with NPI records 22

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

View all 22

All facility ownership & control disclosures 14

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

FacilityTypeRoleSince
State of Mississippi-University of Mississippi Medical CenterJackson, MS, CCN 250001 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jul 1, 2007
Jul 1, 2007
University of Mississi Medical Center- Holmes CountyLexington, MS, CCN 25Z319 Hospital 5% Or Greater Direct Ownership Interest Jan 1, 2004
Ummc- GrenadaGrenada, MS, CCN 250168 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Feb 21, 2014
Feb 21, 2014
Ummc MadisonCanton, MS, CCN 250038 Hospital 5% Or Greater Direct Ownership Interest (100%) May 1, 2025
Ummc MadisonCanton, MS, CCN 25U038 Hospital 5% Or Greater Direct Ownership Interest (100%) May 1, 2025
Lexington Rural Health ClinicLexington, MS, CCN 253813 Rural health clinic 5% Or Greater Direct Ownership Interest May 23, 2013
West Rural Health ClinicWest, MS, CCN 253812 Rural health clinic 5% Or Greater Direct Ownership Interest May 22, 2013
Ummc- Grenada Women's ServicesGrenada, MS, CCN 258626 Rural health clinic 5% Or Greater Direct Ownership Interest Jan 1, 2014
Holmes County Family Medicine Clinic- VaidenVaiden, MS, CCN 258625 Rural health clinic 5% Or Greater Direct Ownership Interest Oct 1, 2016
Ummc Grenada Specialty PediatricsGrenada, MS, CCN 258627 Rural health clinic 5% Or Greater Direct Ownership Interest Jan 1, 2014
Children's of Mississippi Greenwood ClinicGreenwood, MS, CCN 258682 Rural health clinic 5% Or Greater Direct Ownership Interest Oct 1, 2023
Ummc Greenwood Primary Care ClinicGreenwood, MS, CCN 258679 Rural health clinic 5% Or Greater Direct Ownership Interest Oct 1, 2023
Ummc Greenwood Women's ClinicGreenwood, MS, CCN 258680 Rural health clinic 5% Or Greater Direct Ownership Interest Oct 1, 2023
Ummc Grenada Primary Medicine ClinicGrenada, MS, CCN 258681 Rural health clinic 5% Or Greater Direct Ownership Interest Oct 1, 2023

Owned or controlled facilities with NPI records 15

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

View all 15

Facilities with the same owner 14

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

View all 14

Practitioners & affiliated clinicians

Practitioners 502

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.

View all 502

Affiliated clinicians 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544572800000",
    "number": "1386630705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "662-834-1321",
            "fax_number": "601-815-6301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 BOWLING GREEN RD",
            "city": "LEXINGTON",
            "state": "MS",
            "postal_code": "390955167",
            "telephone_number": "662-834-1321",
            "fax_number": "601-815-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-21",
        "last_updated": "2018-12-12",
        "status": "A",
        "authorized_official_last_name": "GRIMSLEY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "601-815-6270",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holmes County Hospital and Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Holmes County Hospital and Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lexington, MS

Sources for this page

Verify at the official NPI Registry.