NPIMap

Organization Active NPI

Tallahatchie General Hospital

  • Critical Access Hospital
  • Charleston, MS
National Provider Identifier
1679733497
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
11-211 Issued in MS
Legal business name
TALLAHATCHIE GENERAL HOSPITAL
Practice address
141 Dr. T.T. Lewis Circle
Charleston, MS 38921
Phone
(662) 647-5535
Fax
(662) 647-8432
NPI assigned
Jun 16, 2008
Last updated
May 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Authorized official

Name
Heather Godsey
Title
Revenue Cycle Manager
Phone
(662) 625-7191

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 11-211 MS Primary
Personal Emergency Response Attendant 146D00000X NU

Addresses

Primary practice location

141 Dr. T.T. Lewis Circle
Charleston, MS 38921

Mailing address

PO Box 230
Charleston, MS 38921-0240
Phone (662) 647-5535

Other identifiers 3

IdentifierTypeStateIssuer
00020161MedicaidMS
000020161OtherMSBLUE CROSS AND BLUE SHIELD OF MS
09012481MedicaidMS

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040303000646 MS Part B Supplier - Clinic/Group Practice 1052208097 Receives reassigned benefits from 25 practitioners
5 other NPIs on this enrollment
Practice locations: Charleston, MS; Grenada, MS; Tutwiler, MS
O20080618000233 MS Part A Provider - Critical Access Hospital 1052208097 Receives reassigned benefits from 22 practitioners
Practice locations: Charleston, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679733497. Details of each certification follow.

Hospital certification: CCN 251304

Legal name
TALLAHATCHIE GENERAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Feb 1, 2002
Last certification
Nov 7, 2018
Beds
18
Ownership / control type
Local
Organization structure
OtherNon-profit
Enrollment address
141 Dr. T. T. Lewis Circle
Charleston, MS 38921-2236
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 5

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Tallahatchie General Hospital-CahCCN 251304 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Tallahatchie General Hospital and Extended Care Facility8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

141 Dr TT Lewis Cir
Charleston, MS 38921
Phone (662) 625-7176

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Tallahatchie General Hospital Organization, Charleston, MS 5% Or Greater Direct Ownership Interest Feb 1, 2002
Heather Godsey Individual W-2 Managing EmployeeRevenue Cycle Director Mar 8, 2024
Charles Weissinger Individual Corporate OfficerCfo Jan 23, 2024
W-2 Managing EmployeeCfo Jan 23, 2024
Frank McRae Individual Corporate OfficerCoo Aug 1, 2016
Donald Blackwood Individual Corporate DirectorAdministrator Feb 1, 2011

Owners & managing parties with NPI records 6

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Holcomb ClinicGrenada, MS, CCN 258601 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2015
Tutwiler ClinicTutwiler, MS, CCN 258620 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2016

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 32

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 32

Affiliated clinicians 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748390400000",
    "number": "1679733497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 230",
            "city": "CHARLESTON",
            "state": "MS",
            "postal_code": "389210240",
            "telephone_number": "662-647-5535",
            "fax_number": "662-647-8432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 DR. T.T. LEWIS CIRCLE",
            "city": "CHARLESTON",
            "state": "MS",
            "postal_code": "38921",
            "telephone_number": "662-647-5535",
            "fax_number": "662-647-8432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TALLAHATCHIE GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-16",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-12",
        "status": "A",
        "authorized_official_last_name": "GODSEY",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "662-625-7191"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "MS",
            "license": "11-211",
            "primary": true
        },
        {
            "code": "146D00000X",
            "taxonomy_group": "",
            "desc": "Personal Emergency Response Attendant",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00020161",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD OF MS",
            "identifier": "000020161",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09012481",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, MS

Sources for this page

Verify at the official NPI Registry.