NPIMap

Organization Active NPI

Forrest County General Hospital

Doing business as Jefferson Davis General Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Prentiss, MS
National Provider Identifier
1649558388
Registry record updated Dec 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
FORREST COUNTY GENERAL HOSPITAL
Doing business as
Jefferson Davis General Hospital
Practice address
1102 Rose St
Prentiss, MS 39474-5200
Phone
(601) 792-4276
Fax
(601) 792-2947
NPI assigned
Jul 29, 2011
Last updated
Dec 20, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2011

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

Authorized official

Name
Richard Andrew Woodard
Title
Chief Financial Officer
Phone
(601) 288-2892

Specialties & licenses 1

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

Addresses

Primary practice location

1102 Rose St
Prentiss, MS 39474-5200

Mailing address

1102 Rose St
Prentiss, MS 39474-5200
Phone (601) 792-4276

Other names 1

  • Jefferson Davis 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
O20120417000156 MS Part A Provider - Critical Access Hospital 1052397767 Practice locations: Prentiss, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649558388. Details of each certification follow.

Hospital certification: CCN 25Z326

Legal name
FORREST COUNTY GENERAL HOSPITAL
Doing business as
JEFFERSON DAVIS COMMUNITY HOSPITAL SWING BED
Organization structure
OtherNon-profit
Enrollment address
1102 Rose Street
Prentiss, MS 39474-5200
Hospital Swing-Bed Unit

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 8

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

NameRoleSinceShare
Erik Steele Individual Corporate OfficerBoard Vice-Chairman Jun 1, 2017
Corporate DirectorBoard Vice-Chairman Jun 1, 2017
Forrest County General Hospital Organization, Hattiesburg, MS Non-profit Operational/Managerial Control Jul 1, 2011 100%
Lewis E Hatten Individual Corporate OfficerBoard Member Jun 1, 2025
Corporate DirectorBoard Member Jun 1, 2025
Ben R Hester Individual Corporate DirectorCfo Aug 1, 2015
W-2 Managing EmployeeCfo Aug 1, 2015
Operational/Managerial ControlCfo Aug 1, 2015
Peggy Answorth Individual Corporate OfficerBoard Secretary Apr 1, 2023
Corporate DirectorBoard Secretary Apr 1, 2023
Andrew B. Mercier Individual Corporate OfficerBoard Member Mar 1, 2024
Corporate DirectorBoard Member Mar 1, 2024
Shea McNease Individual Corporate OfficerBoard Member Aug 1, 2024
Corporate DirectorBoard Member Aug 1, 2024
Harry Chip McArthur Individual Corporate OfficerBoard Member Aug 1, 2024
Corporate DirectorBoard Member Aug 1, 2024

Owners & managing parties with NPI records 25

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

View all 25

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
Marion General HospitalColumbia, MS, CCN 25U085 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2012
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 5

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": "1311897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324339200000",
    "number": "1649558388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 ROSE ST",
            "city": "PRENTISS",
            "state": "MS",
            "postal_code": "394745200",
            "telephone_number": "601-792-4276",
            "fax_number": "601-792-2947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 ROSE ST",
            "city": "PRENTISS",
            "state": "MS",
            "postal_code": "394745200",
            "telephone_number": "601-792-4276",
            "fax_number": "601-792-2947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORREST COUNTY GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-29",
        "last_updated": "2011-12-20",
        "status": "A",
        "authorized_official_last_name": "WOODARD",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "601-288-2892"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jefferson Davis General Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prentiss, MS

Sources for this page

Verify at the official NPI Registry.