NPIMap

Organization Active NPI

Franklin County Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Meadville, MS
National Provider Identifier
1649503699
Registry record updated Feb 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
11175 Issued in MS
Legal business name
FRANKLIN COUNTY MEMORIAL HOSPITAL
Practice address
40 Union Church Rd
Meadville, MS 39653-8336
Phone
(601) 384-5801
Fax
(601) 384-4100
NPI assigned
Sep 9, 2009
Last updated
Feb 16, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
FRANKLIN COUONTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 16, 2015

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

Authorized official

Name
Mike Boleware
Title
Administrator
Phone
(601) 384-5801

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 11175 MS Primary

Addresses

Primary practice location

40 Union Church Rd
Meadville, MS 39653-8336

Mailing address

P.O. Box 636
Meadville, MS 39653
Phone (601) 384-5801

Other identifiers 2

IdentifierTypeStateIssuer
000080019OtherMSBLUE CROSS BLUE SHIELD
00029130MedicaidMS

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040129000396 MS Part B Supplier - Clinic/Group Practice 2466355243 Receives reassigned benefits from 47 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bude, MS; Meadville, MS
O20220809001459 MS Part A Provider - Critical Access Hospital 2466355243 Practice locations: Meadville, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649503699. Details of each certification follow.

Hospital certification: CCN 25Z330

Legal name
FRANKLIN COUNTY MEMORIAL HOSPITAL
Doing business as
FRANKLIN COUNTY MEMORIAL SWING BED
Organization structure
OtherNon-profit
Enrollment address
40 Union Church Rd
Meadville, MS 39653-8336
Hospital Swing-Bed Unit

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 4

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

National Provider Directory

National Provider Directory
Part of
Franklin Cty Mem Hosp

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Mike Boleware Individual Contracted Managing EmployeeAdministrator Oct 7, 2015
Corporate DirectorAdministrator Oct 7, 2015
Operational/Managerial Control Jan 1, 2014

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Franklin County Memorial HospitalMeadville, MS, CCN 251330 Hospital Operational/Managerial Control (100%) Sep 1, 2008
Family Medical GroupMeadville, MS, CCN 253995 Rural health clinic Other Nov 2, 1993

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 8

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.

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": "1252454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424044800000",
    "number": "1649503699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 636",
            "city": "MEADVILLE",
            "state": "MS",
            "postal_code": "39653",
            "telephone_number": "601-384-5801",
            "fax_number": "601-384-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 UNION CHURCH RD",
            "city": "MEADVILLE",
            "state": "MS",
            "postal_code": "396538336",
            "telephone_number": "601-384-5801",
            "fax_number": "601-384-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANKLIN COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANKLIN COUONTY MEMORIAL HOSPITAL",
        "enumeration_date": "2009-09-09",
        "last_updated": "2015-02-16",
        "status": "A",
        "authorized_official_last_name": "BOLEWARE",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "601-384-5801"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "MS",
            "license": "11175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000080019",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00029130",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meadville, MS

Sources for this page

Verify at the official NPI Registry.