Wayne General Hospital

Organization Active NPI General Acute Care Hospital · Waynesboro, MS

NPI 1679559983 · NPPES record last updated Mar 25, 2026

Key facts

NPI
1679559983
Entity type
Organization (NPI type 2)
Primary specialty
General Acute Care Hospital 282N00000X
License
11288 (MS)
Legal business name
WAYNE GENERAL HOSPITAL
Practice address
950 Matthew Dr
Waynesboro, MS 39367-2567
Phone
(601) 735-5151
Fax
(601) 735-7168
NPI assigned
Dec 19, 2005
Organization subpart
No

Authorized official

Name
David Andrew Porter
Title
Ceo
Phone
(601) 735-5151

Owners & managing parties with NPI records 8

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

Owned or controlled facilities with NPI records 4

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

Other NPIs with the same Medicare PAC ID 7

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

Corporate family (same tax ID) 13

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

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

Facilities with the same owner 4

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

Practitioners 49

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

View all 49

Affiliated clinicians 125

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

View all 125

Medicare Care Compare: Hospital

Listed as
Wayne General Hospital CCN 250077
Overall star rating
★★★☆☆ 3 of 5
Type
Acute Care Hospitals
Ownership
Government - Local
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MS

Hospital certification: CCN 250077

Legal name
WAYNE GENERAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
May 21, 1967
Last certification
Jun 30, 2010
Beds
80
Ownership / control type
Local
Organization structure
Other · Proprietary
Incorporated
in MS
Enrollment address
950 Matthew Dr
Waynesboro, MS 39367-2567
Other Hospital Practice Location
Hospital subgroups
Acute care

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
Laura Barnett
Individual
Corporate Officer
Trustee
Jan 1, 2023
Johnnie Odom
Individual
Corporate Officer
Trustee
Jan 1, 2002
Wayne General Hospital
Organization · Waynesboro, MS
5% Or Greater Direct Ownership Interest May 21, 1967
Operational/Managerial Control May 21, 1967
Martin Stadalis
Individual
Corporate Director
Trustee
Jan 1, 2002
Raymond Cooley
Individual
Corporate Officer
Trustee
Jun 20, 2016
Lonnie Sanderson
Individual
Corporate Officer
Trustee
Sep 7, 2021
David a Porter
Individual
Corporate Officer
Ceo
Sep 5, 2023
W-2 Managing Employee
Ceo
Sep 5, 2023
Laura Kelley
Individual
Corporate Officer
Trustee
Sep 19, 2019
Daryll McDonald
Individual
Corporate Officer May 1, 2023

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Wayne General Hospital
Waynesboro, MS · CCN 25U077
Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control
Aug 8, 1989
Aug 8, 1989
Wayne General Hospital
Waynesboro, MS · CCN 257088
Home health agency 5% Or Greater Direct Ownership Interest (100%) Oct 1, 1978
Wayne General Hospital
Waynesboro, MS · CCN 258546
Rural health clinic 5% Or Greater Direct Ownership Interest Sep 2, 2008
Wayne General School Clinic
Waynesboro, MS · CCN 258652
Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2021

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080610000191 MS Part a Provider - Hospital 2668457581 Practice locations: Waynesboro, MS

National Provider Directory

Tax ID family
Arthur E Medical Clinic (14 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 11288 MS Yes

Addresses

Primary practice location

950 Matthew Dr
Waynesboro, MS 39367-2567

Mailing address

950 Matthew Dr
Waynesboro, MS 39367-2567
Phone (601) 735-5151

Other identifiers

IdentifierTypeStateIssuer
25U077OtherMSMEDICARE SWINGBED
HOS0077PMedicaidAL
00020131MedicaidMS

Other providers in Waynesboro, MS

All providers in Waynesboro, MS · General Acute Care Hospital in Mississippi

Sources for this page

Verify at the official NPI Registry.