NPIMap

Kemper Cah, Inc.

Organization Active NPI Critical Access Hospital · De Kalb, MS

NPI 1679875645 · NPPES record last updated Dec 22, 2022

Key facts

NPI
1679875645
Entity type
Organization (NPI type 2)
Primary specialty
Critical Access Hospital 282NC0060X
Legal business name
KEMPER CAH, INC.
Practice address
14365 Highway 16 W
De Kalb, MS 39328-7974
Phone
(769) 486-1000
Fax
(769) 486-1099
NPI assigned
Nov 24, 2010
Organization subpart
No

Authorized official

Name
Don Larkin Kennedy
Title
Regional Ceo
Phone
(601) 703-9614

Owners & managing parties with NPI records 10

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

Other NPIs with the same Medicare PAC ID 6

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

Member of 3

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

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

Facilities with the same owner 75

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

View all 75

Practitioners 60

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

View all 60

Affiliated clinicians 49

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

View all 49

Medicare Care Compare: Hospital

Listed as
Ochsner Stennis Memorial Hospital CCN 251335
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
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 251335

Legal name
KEMPER CAH, INC.
Doing business as
OCHSNER STENNIS HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jul 28, 2011
Last certification
Feb 24, 2022
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
Corporation · Non-profit
Enrollment address
14365 Highway 16 W
De Kalb, MS 39328-7974
Other Hospital Practice Location

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Johnathan Y Lee
Individual 		Corporate Director
Governing Board,Rush Health Systems		 Jul 1, 2022
Operational/Managerial Control
Governing Board,Rush Health Systems		 Jul 1, 2022
Kristin K. Molony
Individual 		W-2 Managing Employee
Administrator		 Jul 1, 2022
Operational/Managerial Control
Administrator		 Jul 1, 2022
Michael F Hulefeld
Individual 		Corporate Officer
President, Coo		 Nov 1, 2022
Corporate Director
Member of Governing Board		 Jul 1, 2022
Operational/Managerial Control
Member of Governing Board		 Jul 1, 2022
Faye Martin
Individual 		Corporate Director
Governing Board,Rush Health Systems		 Jul 1, 2022
Operational/Managerial Control
Governing Board, Rush Health System		 Jul 1, 2022
Alan Gartrell
Individual 		Corporate Director
Governing Board,Rush Health Systems		 Jul 1, 2022
Operational/Managerial Control
Governing Board,Rush Health Systems		 Jul 1, 2022
Rush Medical Foundation
Organization · Meridian, MS
Corporation, Medical provider/supplier, Non-profit 		5% Or Greater Mortgage Interest Jan 1, 2020
Peter C November
Individual 		Corporate Officer
Chief Executive Officer		 Nov 1, 2022
Corporate Director
Member of Governing Board		 Jul 1, 2022
Operational/Managerial Control
Member of Governing Board		 Jul 1, 2022
James M Molloy
Individual 		Corporate Officer
Executive VP, Cfo, Treasurer		 Jan 1, 2024
Darrell Wildman
Individual 		Corporate Director
Governing Board,Rush Health Systems		 Jul 1, 2022
Operational/Managerial Control
Governing Board,Rush Health Systems		 Jul 1, 2022
Ochsner Clinic Foundation
Organization · New Orleans, LA
Corporation, Non-profit 		5% Or Greater Indirect Ownership Interest Jul 1, 2022 100%
Operational/Managerial Control Jul 1, 2022
Don L Kennedy
Individual 		Corporate Officer
Regional Chief Executive Officer		 Jul 1, 2022
W-2 Managing Employee
Regional Chief Executive Officer		 Jul 1, 2022
Operational/Managerial Control
Regional Chief Executive Officer,Ru		 Jul 1, 2022
Rush Health Systems Inc
Organization · Meridian, MS
Corporation, Non-profit 		5% Or Greater Direct Ownership Interest Jul 1, 2022 100%
Operational/Managerial Control May 19, 2011
David L Butler
Individual 		Corporate Officer
Chief Financial Officer,Rush Hea		 Jul 1, 2022
W-2 Managing Employee
Chief Financial Officer,Rush Hea		 Jul 1, 2022
Operational/Managerial Control
Chief Financial Officer,Rush Health		 Jul 1, 2022

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20110721000914 MS Part a Provider - Critical Access Hospital 5991985012 Receives reassigned benefits from 37 practitioners
Practice locations: De Kalb, MS

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Yes

Addresses

Primary practice location

14365 Highway 16 W
De Kalb, MS 39328-7974

Mailing address

Dept 3018
PO Box 1000
Memphis, TN 38148
Phone (601) 213-3010

Other identifiers

IdentifierTypeStateIssuer
002934741MedicaidMS

Other names

  • Ochsner Stennis Hospital Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Other providers in De Kalb, MS

All providers in De Kalb, MS · Critical Access Hospital in Mississippi

Sources for this page

Verify at the official NPI Registry.