NPIMap

Organization Active NPI

Baptist Memorial Hospital Union County, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • New Albany, MS
National Provider Identifier
1659537280
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
16239 Issued in MS
Legal business name
BAPTIST MEMORIAL HOSPITAL UNION COUNTY, INC.
Practice address
200 Hwy 30 W
New Albany, MS 38652-3112
Phone
(662) 538-7631
NPI assigned
Aug 4, 2008
Organization subpart
Yes
Parent organization
BAPTIST MEMORIAL HEALTH CARE CORP.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 16239 MS Primary

Addresses

Primary practice location

200 Hwy 30 W
New Albany, MS 38652-3112

Mailing address

350 N Humphreys Blvd
Memphis, TN 38120-2177
Phone (662) 538-7631

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081013000105 MS Part A Provider - Hospital 4183601305 Practice locations: New Albany, MS

Hospital certification: CCN 25U006

Legal name
BAPTIST MEMORIAL HOSPITAL UNION COUNTY, INC.
Doing business as
BMH - UNION COUNTY
Organization structure
CorporationNon-profit
Incorporated
Mar 22, 1989 in MS
Enrollment address
200 State Highway 30 West
New Albany, MS 38652-3112
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 1

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

National Provider Directory

National Provider Directory
Tax ID family
BMH Union County DME5 organizations share this tax ID, including this one
Part of
Baptist Memorial Health Care Corp

Other organizations with this tax ID 4

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

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
Jason M Little Individual Corporate OfficerVP Jan 14, 2013
John Stanford Individual Corporate DirectorBoard Member Apr 24, 2008
Gary C Anderson Individual Corporate DirectorVP Jan 1, 2024
Arthur Maples Individual Corporate DirectorDelegated Official Dec 14, 2020
Rusty Berryhill Individual Corporate DirectorBoard Member Jan 1, 2024
Colt Doom Individual Corporate DirectorChairman Jan 1, 2023
Gregory M Duckett Individual Corporate OfficerSr VP/Corp Sec Jan 1, 2000
Baptist Memorial Health Care Corporation Organization, New Albany, MS Non-profit 5% Or Greater Indirect Ownership Interest Mar 22, 1989 100%
Anna Bishop Individual W-2 Managing EmployeeAd; Apr 1, 2023

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
BMH - Union CountyNew Albany, MS, CCN 250006 Hospital 5% Or Greater Direct Ownership Interest (100%) Mar 22, 1989

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 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 43

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": "1217808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601424000000",
    "number": "1659537280",
    "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",
            "telephone_number": "662-538-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HWY 30 W",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386523112",
            "telephone_number": "662-538-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST MEMORIAL HOSPITAL UNION COUNTY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAPTIST MEMORIAL HEALTH CARE CORP.",
        "enumeration_date": "2008-08-04",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "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"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "MS",
            "license": "16239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, MS

Sources for this page

Verify at the official NPI Registry.