Organization Active NPI

Kemper Cah, Inc.

Doing business as Ochsner Stennis Hospital

  • Critical Access Hospital
  • De Kalb, MS
National Provider Identifier
1679875645
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
KEMPER CAH, INC.
Doing business as
Ochsner Stennis Hospital
Practice address
14365 Highway 16 W
De Kalb, MS 39328-7974
Phone
(769) 486-1000
Fax
(769) 486-1099
NPI assigned
Nov 24, 2010
Last updated
Dec 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

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 names 1

  • Ochsner Stennis Hospital Doing business as

Electronic endpoints 1

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

Medicare participation

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

Enrollment records 1

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679875645. Details of each certification follow.

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
CorporationNon-profit
Enrollment address
14365 Highway 16 W
De Kalb, MS 39328-7974
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).

Care Compare: Hospital

Medicare Care Compare
Listed as
Ochsner Stennis Memorial HospitalCCN 251335 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member of 3

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

Ownership & related parties

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 DirectorGoverning Board,Rush Health Systems Jul 1, 2022
Operational/Managerial ControlGoverning Board,Rush Health Systems Jul 1, 2022
Kristin K. Molony Individual W-2 Managing EmployeeAdministrator Jul 1, 2022
Operational/Managerial ControlAdministrator Jul 1, 2022
Michael F Hulefeld Individual Corporate OfficerPresident, Coo Nov 1, 2022
Corporate DirectorMember of Governing Board Jul 1, 2022
Operational/Managerial ControlMember of Governing Board Jul 1, 2022
Faye Martin Individual Corporate DirectorGoverning Board,Rush Health Systems Jul 1, 2022
Operational/Managerial ControlGoverning Board, Rush Health System Jul 1, 2022
Alan Gartrell Individual Corporate DirectorGoverning Board,Rush Health Systems Jul 1, 2022
Operational/Managerial ControlGoverning 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 OfficerChief Executive Officer Nov 1, 2022
Corporate DirectorMember of Governing Board Jul 1, 2022
Operational/Managerial ControlMember of Governing Board Jul 1, 2022
James M Molloy Individual Corporate OfficerExecutive VP, Cfo, Treasurer Jan 1, 2024
Darrell Wildman Individual Corporate DirectorGoverning Board,Rush Health Systems Jul 1, 2022
Operational/Managerial ControlGoverning 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 OfficerRegional Chief Executive Officer Jul 1, 2022
W-2 Managing EmployeeRegional Chief Executive Officer Jul 1, 2022
Operational/Managerial ControlRegional 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 OfficerChief Financial Officer,Rush Hea Jul 1, 2022
W-2 Managing EmployeeChief Financial Officer,Rush Hea Jul 1, 2022
Operational/Managerial ControlChief Financial Officer,Rush Health Jul 1, 2022

Owners & managing parties with NPI records 10

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

Facilities with the same owner 75

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

View all 75

Practitioners & affiliated clinicians

Practitioners 37

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 37

Affiliated clinicians 49

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

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1290556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671667200000",
    "number": "1679875645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 3018",
            "address_2": "PO BOX 1000",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38148",
            "telephone_number": "601-213-3010",
            "fax_number": "601-213-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14365 HIGHWAY 16 W",
            "city": "DE KALB",
            "state": "MS",
            "postal_code": "393287974",
            "telephone_number": "769-486-1000",
            "fax_number": "769-486-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEMPER CAH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-24",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "DON",
        "authorized_official_middle_name": "LARKIN",
        "authorized_official_title_or_position": "REGIONAL CEO",
        "authorized_official_telephone_number": "601-703-9614"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Ochsner Stennis Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in De Kalb, MS

Sources for this page

Verify at the official NPI Registry.