NPIMap

Organization Active NPI

Baptist Medical Center - Yazoo, Inc

  • Critical Access Hospital
  • Yazoo City, MS
National Provider Identifier
1619918075
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
BAPTIST MEDICAL CENTER - YAZOO, INC
Practice address
823 Grand Ave
Yazoo City, MS 39194-3233
Phone
(662) 746-2261
Fax
(662) 746-4839
NPI assigned
Jun 9, 2006
Last updated
Sep 29, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
BAPTIST MEMORIAL HEALTH CARE CORP.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X MS Primary

Addresses

Primary practice location

823 Grand Ave
Yazoo City, MS 39194-3233

Mailing address

350 N Humphreys Blvd
Memphis, TN 38120-2177

Other identifiers 2

IdentifierTypeStateIssuer
20253OtherMSBCBS HOSPITAL
000020082MedicaidMS

Other names 1

  • King's Daughters Hospital of Yazoo County, Inc. Former legal business name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080815000433 MS Part B Supplier - Clinic/Group Practice 5799850376 Receives reassigned benefits from 44 practitioners
2 other NPIs on this enrollment
Practice locations: Yazoo City, MS
O20110412000435 MS Part A Provider - Critical Access Hospital 5799850376 Receives reassigned benefits from 1 practitioner
Practice locations: Yazoo City, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1619918075. Details of each certification follow.

Hospital certification: CCN 251313

Legal name
BAPTIST MEDICAL CENTER - YAZOO, INC.
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 1, 2003
Last certification
Feb 9, 2023
Beds
35
Ownership / control type
Private (not for profit)
Organization structure
CorporationProprietary
Incorporated
Jul 7, 1986 in MS
Enrollment address
823 Grand Ave
Yazoo City, MS 39194-3233
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Baptist Medical Center-YazooCCN 251313 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
Baptist Memorial Health Care Corp

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 11

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 Nov 24, 2020
John Michael Pillow Individual Corporate Officer Jan 1, 2024
McCafferty Flynt Individual W-2 Managing EmployeeCeo May 1, 2023
Arthur Maples Individual Corporate DirectorBoard Member Nov 24, 2020
Janice Adams Individual Corporate Officer Jan 1, 2024
Jamey Carter Individual Corporate Officer Jan 1, 2024
Gregory M Duckett Individual Corporate OfficerCorp Sec at Bmhcc May 1, 2017
Vernette Griffin Individual Corporate Officer Jan 1, 2024
Mississippi Baptist Health Systems, Inc Organization, Jackson, MS Corporation, Non-profit 5% Or Greater Direct Ownership Interest Feb 1, 2015 100%
Baptist Memorial Health Care Corporation Organization, Memphis, TN Non-profit 5% Or Greater Indirect Ownership Interest May 1, 2017 100%
Ritchie Moore Individual Corporate Officer Jan 1, 2024

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Baptist Medical Group- Yazoo Primary CareYazoo City, MS, CCN 258591 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 25, 2011

Owned or controlled facilities with NPI records 1

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 47

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 47

Affiliated clinicians 89

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

View all 89

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601337600000",
    "number": "1619918075",
    "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": "823 GRAND AVE",
            "city": "YAZOO CITY",
            "state": "MS",
            "postal_code": "391943233",
            "telephone_number": "662-746-2261",
            "fax_number": "662-746-4839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST MEDICAL CENTER - YAZOO, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAPTIST MEMORIAL HEALTH CARE CORP.",
        "enumeration_date": "2006-06-09",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS HOSPITAL",
            "identifier": "20253",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000020082",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "King's Daughters Hospital of Yazoo County, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "King's Daughters Hospital of Yazoo County, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Yazoo City, MS

Sources for this page

Verify at the official NPI Registry.