Forrest County General Hospital
Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Columbia, MS
NPI 1609148170 · NPPES record last updated Jan 31, 2012
Key facts
- NPI
- 1609148170
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medicare Defined Swing Bed Hospital Unit 275N00000X
- License
- 11167 (MS)
- Legal business name
- FORREST COUNTY GENERAL HOSPITAL
- Practice address
- 1560 Sumrall Rd
Columbia, MS 39429-2654 - Phone
- (601) 736-6303
- Fax
- (601) 740-2244
- NPI assigned
- Jan 31, 2012
- Organization subpart
- No
Authorized official
- Name
- Mr. Richard Andrews Woodard
- Title
- Chief Financial Officer
- Phone
- (601) 288-2892
Owners & managing parties with NPI records 24
Owned or controlled facilities with NPI records 16
Other NPIs with the same Medicare PAC ID 24
Corporate family (same tax ID) 40
Related certifications (CCN) 1
Facilities with the same owner 16
Practitioners 107
-
L. Wesley Aldred, M.D.
-
George M Anderson, M.D.
-
Joseph Anderson, PMHNP-BC
-
Roopsi Bassi, MD
-
Berthold Beisel, MD
-
Siddeeqah Bilal, M.D.
-
Santo M Borganelli, MD FACC
-
Stephanie Kay Bounds, PMHNP-BC
-
Robert B Brahan, MD
-
Karen H Bruce, M.D.
-
Jefferson Buntin, N.P.
-
Heather Conn, FNP, PMHNP-BC
-
Courtney Lynn Cruthirds, PMHNP
-
Justin Defee, LPC
-
Christopher John Douglas, M.D.
Affiliated clinicians 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Hospital certification: CCN 25U085
- Legal name
- FORREST COUNTY GENERAL HOSPITAL
- Doing business as
- MARION GENERAL HOSPITAL
- Organization structure
- Government · Non-profit
- Enrollment address
- 1560 Sumrall Road
Marion General Hospital
Columbia, MS 39429-2654 - Hospital subgroups
- Swing-bed approved
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| Forrest County General Hospital |
5% Or Greater Direct Ownership Interest | Jan 1, 2012 | 100% |
| James Lynn Cartlidge |
Corporate Director | Jan 24, 2012 | |
| Douglas a Jones |
Corporate Officer | Jan 1, 2012 | |
| W-2 Managing Employee | Jan 1, 2012 | ||
| Richard Andy Woodard |
Corporate Officer | Jan 1, 2012 | |
| W-2 Managing Employee | Jan 1, 2012 | ||
| Ben R Hester |
Corporate Director |
Aug 1, 2015 | |
| W-2 Managing Employee |
Aug 1, 2015 | ||
| Operational/Managerial Control |
Aug 1, 2015 | ||
| Reginald Woullard |
Corporate Officer | Jan 1, 2012 | |
| Corporate Director | Jan 1, 2012 | ||
| Bryan K Maxie |
W-2 Managing Employee | Nov 1, 2011 | |
| Marcus L Hogan |
Corporate Director | Jan 1, 2012 | |
| Richard W Preusch |
Corporate Officer | Jan 1, 2012 | |
| Corporate Director | Jan 1, 2012 |
All facility ownership & control disclosures 16
| Facility | Type | Role | Since |
|---|---|---|---|
| Highland Community Hospital |
Hospital | 5% Or Greater Direct Ownership Interest Operational/Managerial Control |
May 1, 2006 May 1, 2006 |
| The Orthopedic Institute |
Hospital | 5% Or Greater Direct Ownership Interest | Jul 15, 1952 |
| Marion General Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2012 |
| Jefferson Davis Community Hospital Swing Bed |
Hospital | Operational/Managerial Control (100%) | Jul 1, 2011 |
| Pearl River County Hospital and Nursing Home |
Hospital | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Feb 1, 2020 Feb 1, 2020 |
| Pearl River County Hospital Swing Bed |
Hospital | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Feb 1, 2020 Feb 1, 2020 |
| Jefferson Davis Extended Care Facility |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2012 |
| Pearl River County Hospital and Nursing Home |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Feb 1, 2020 Feb 1, 2020 |
| Forrest General Home Care of Marion General |
Home health agency | 5% Or Greater Direct Ownership Interest | Jan 1, 2012 |
| Jefferson Davis Rural Health Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest Operational/Managerial Control |
Jul 1, 2011 Jul 1, 2011 |
| Marion County General Hospital |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Oct 1, 2014 Oct 1, 2007 |
| Highland Pediatric and Primary Care Rural Health Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Dec 1, 2018 Dec 1, 2018 |
| Forrest County General Hospital |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Feb 1, 2020 Feb 1, 2020 |
| Highland Center for Women'S Health |
Rural health clinic | Operational/Managerial Control | Aug 13, 2017 |
| Forrest County General Hospital |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2022 |
| Highland Family Medicine Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jun 1, 2022 Jun 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120320000909 | MS | Part a Provider - Hospital | 1052397767 | Practice locations: Columbia, MS |
National Provider Directory
- Tax ID family
- Forrest County Gen Hospital
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | 11167 | MS | Yes |
Addresses
Primary practice location
1560 Sumrall Rd
Columbia, MS 39429-2654
Mailing address
1560 Sumrall Rd
Columbia, MS 39429-2654
Phone (601) 736-6303
Other names
- Marion General Hospital
Other providers in Columbia, MS
- Forrest County General Hospital
- Forrest County General Hospital
- Forrest County General Hospital
- Forrest County General Hospital
- Forrest County General Hospital
- Amarion Fortenberry
- Sabrina Fortenberry
- Xiaria Fortenberry
- Rashan Foxworth
- Lakesha Shanell Franklin
All providers in Columbia, MS · Medicare Defined Swing Bed Hospital Unit in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.