NPIMap

Organization Active NPI

Forrest County General Hospital

Doing business as Marion General Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Columbia, MS
National Provider Identifier
1609148170
Registry record updated Jan 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
11167 Issued in MS
Legal business name
FORREST COUNTY GENERAL HOSPITAL
Doing business as
Marion General Hospital
Practice address
1560 Sumrall Rd
Columbia, MS 39429-2654
Phone
(601) 736-6303
Fax
(601) 740-2244
NPI assigned
Jan 31, 2012
Last updated
Jan 31, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2012

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

Authorized official

Name
Mr. Richard Andrews Woodard
Title
Chief Financial Officer
Phone
(601) 288-2892

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 11167 MS Primary

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 1

  • Marion General Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120320000909 MS Part A Provider - Hospital 1052397767 Practice locations: Columbia, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609148170. Details of each certification follow.

Hospital certification: CCN 25U085

Legal name
FORREST COUNTY GENERAL HOSPITAL
Doing business as
MARION GENERAL HOSPITAL
Organization structure
GovernmentNon-profit
Enrollment address
1560 Sumrall Road
Marion General Hospital
Columbia, MS 39429-2654
Hospital Swing-Bed Unit
Hospital subgroups
Swing-bed approved

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

Other NPIs with the same Medicare PAC ID 24

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

View all 24

National Provider Directory

National Provider Directory
Tax ID family
Forrest Cty Gen Hosp41 organizations share this tax ID, including this one

Other organizations with this tax ID 40

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

View all 40

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Forrest County General Hospital Organization, Hattiesburg, MS 5% Or Greater Direct Ownership Interest Jan 1, 2012 100%
James Lynn Cartlidge Individual Corporate Director Jan 24, 2012
Douglas a Jones Individual Corporate Officer Jan 1, 2012
W-2 Managing Employee Jan 1, 2012
Richard Andy Woodard Individual Corporate Officer Jan 1, 2012
W-2 Managing Employee Jan 1, 2012
Ben R Hester Individual Corporate DirectorCfo Aug 1, 2015
W-2 Managing EmployeeCfo Aug 1, 2015
Operational/Managerial ControlCfo Aug 1, 2015
Reginald Woullard Individual Corporate Officer Jan 1, 2012
Corporate Director Jan 1, 2012
Bryan K Maxie Individual W-2 Managing Employee Nov 1, 2011
Marcus L Hogan Individual Corporate Director Jan 1, 2012
Richard W Preusch Individual Corporate Officer Jan 1, 2012
Corporate Director Jan 1, 2012

Owners & managing parties with NPI records 24

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

View all 24

All facility ownership & control disclosures 16

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

FacilityTypeRoleSince
Highland Community HospitalPicayune, MS, CCN 250117 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 May 1, 2006
May 1, 2006
The Orthopedic InstituteHattiesburg, MS, CCN 250078 Hospital 5% Or Greater Direct Ownership Interest Jul 15, 1952
Marion General HospitalColumbia, MS, CCN 250085 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2012
Jefferson Davis Community Hospital Swing BedPrentiss, MS, CCN 25Z326 Hospital Operational/Managerial Control (100%) Jul 1, 2011
Pearl River County Hospital and Nursing HomePoplarville, MS, CCN 251333 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Feb 1, 2020
Feb 1, 2020
Pearl River County Hospital Swing BedPoplarville, MS, CCN 25Z333 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Feb 1, 2020
Feb 1, 2020
Jefferson Davis Extended Care FacilityPrentiss, MS, CCN 255050 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2012
Pearl River County Hospital and Nursing HomePoplarville, MS, CCN 255349 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 GeneralColumbia, MS, CCN 257089 Home health agency 5% Or Greater Direct Ownership Interest Jan 1, 2012
Jefferson Davis Rural Health ClinicPrentiss, MS, CCN 258523 Rural health clinic 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jul 1, 2011
Jul 1, 2011
Marion County General HospitalColumbia, MS, CCN 258612 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 ClinicPicayune, MS, CCN 258631 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Dec 1, 2018
Dec 1, 2018
Forrest County General HospitalPoplarville, MS, CCN 258556 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 HealthPicayune, MS, CCN 258683 Rural health clinic Operational/Managerial Control Aug 13, 2017
Forrest County General HospitalRichton, MS, CCN 253452 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2022
Highland Family Medicine ClinicPicayune, MS, CCN 258673 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jun 1, 2022
Jun 1, 2022

Owned or controlled facilities with NPI records 16

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

View all 16

Facilities with the same owner 16

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

View all 16

Practitioners & affiliated clinicians

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1327968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327968000000",
    "number": "1609148170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 SUMRALL RD",
            "city": "COLUMBIA",
            "state": "MS",
            "postal_code": "394292654",
            "telephone_number": "601-736-6303",
            "fax_number": "601-740-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 SUMRALL RD",
            "city": "COLUMBIA",
            "state": "MS",
            "postal_code": "394292654",
            "telephone_number": "601-736-6303",
            "fax_number": "601-740-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORREST COUNTY GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-31",
        "last_updated": "2012-01-31",
        "status": "A",
        "authorized_official_last_name": "WOODARD",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ANDREWS",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "601-288-2892",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "MS",
            "license": "11167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marion General Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, MS

Sources for this page

Verify at the official NPI Registry.