NPIMap

Organization Active NPI

State of Mississippi - University of Mississippi Medical Center

Doing business as UMMC Greenwood Hospital

  • General Acute Care Hospital
  • Greenwood, MS
National Provider Identifier
1699714717
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
11065 Issued in MS
Legal business name
STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Doing business as
UMMC Greenwood Hospital
Practice address
1401 River Rd
Greenwood, MS 38930-4030
Phone
(662) 459-2604
NPI assigned
Jun 5, 2006
Last updated
Jul 31, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Authorized official

Name
Kimberley Wrenn Martindale
Title
Director of Reimbursement
Phone
(601) 815-6381

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 11065 MS Primary

Addresses

Primary practice location

1401 River Rd
Greenwood, MS 38930-4030

Mailing address

504 Clinton Center Dr Ste 4100
Clinton, MS 39056-5610
Phone (601) 815-6381

Other names 2

  • UMMC Greenwood Hospital Doing business as
  • State of Mississippi - University of Mississippi Medical Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040923000500 MS Part B Supplier - Clinic/Group Practice 1153399472 Receives reassigned benefits from 79 practitioners
1 other NPI on this enrollment
Practice locations: Greenwood, MS
O20080115000724 MS Part A Provider - Hospital 1153399472 Practice locations: Greenwood, MS
O20250523001893 MS Part A Provider - Hospital 1153399472 Practice locations: Greenwood, MS

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1699714717. Details of each certification follow.

Hospital certification: CCN 250099

Legal name
GREENWOOD LEFLORE HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Feb 17, 1969
Last certification
Jun 20, 2024
Beds
260 (244 certified)
Ownership / control type
Local
Organization structure
OtherNon-profit
Enrollment address
1401 River Rd
Greenwood, MS 38930-4030
Main/Primary Hospital Location
Hospital subgroups
Acute care

Hospital certification: CCN 25U099

Legal name
GREENWOOD LEFLORE HOSPITAL
Organization structure
OtherNon-profit
Enrollment address
1401 River Rd
Greenwood, MS 38930-4030
Hospital Swing-Bed Unit
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 2

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Greenwood Leflore HospitalCCN 250099 · All quality measures
Overall star rating
1 of 5
Type
Acute Care 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
Sigurds O Krolls MD62 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Member of 1

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

Locations

504 Clinton Center Dr
Ste 4100
Clinton, MS 39056

1413 Strong Ave
Greenwood, MS 38930
Phone (662) 459-1207

1601 Strong Ave
Greenwood, MS 38930
Phone (662) 451-7565

203 9th St
Greenwood, MS 38930
Phone (662) 227-7020

706 Highway 82 W
Ste B
Greenwood, MS 38930
Phone (662) 459-2181

100 N Court St
Sumner, MS 38957
Phone (662) 375-9989

Interoperability endpoints

  • Direct secure messaging: abhash.thakur@scs-direct.glh.org
  • Direct secure messaging: alain.domkam@scs-direct.glh.org
  • Direct secure messaging: billy.boldon@scs-direct.glh.org
  • Direct secure messaging: byron.windham@scs-direct.glh.org
  • Direct secure messaging: canon.beissel@scs-direct.glh.org
  • Direct secure messaging: claudine.stevens@scs-direct.glh.org
  • Direct secure messaging: elizabeth.whites@scs-direct.glh.org
  • Direct secure messaging: jay.culpepper@scs-direct.glh.org
  • Direct secure messaging: joseph.bennett@scs-direct.glh.org
  • Direct secure messaging: kimberly.sanford@scs-direct.glh.org
  • Direct secure messaging: michael.portner@scs-direct.glh.org
  • Direct secure messaging: preston.boles@scs-direct.glh.org
  • Direct secure messaging: rachael.faught@scs-direct.glh.org
  • Direct secure messaging: ravi.pande@scs-direct.glh.org
  • Direct secure messaging: richard.goldberg@scs-direct.glh.org
  • Direct secure messaging: roger.blake@scs-direct.glh.org
  • Direct secure messaging: sarah.rentrop@scs-direct.glh.org
  • Direct secure messaging: syed.rafique@scs-direct.glh.org
  • Direct secure messaging: william.jones@scs-direct.glh.org
  • Direct secure messaging: william.windham@scs-direct.glh.org

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 Allen Studley Individual Corporate OfficerCeo Oct 19, 2020
Corporate DirectorCeo Oct 19, 2020
Harris Powers Individual Corporate DirectorBoard Chairman Sep 18, 2018
Marcus Banks Individual Corporate DirectorBoard Member Sep 18, 2018
City of Greenwood Organization, Greenwood, MS 5% Or Greater Indirect Ownership Interest Jan 1, 1966 50%
Leflore County Board of Supervisors Organization, Greenwood, MS 5% Or Greater Indirect Ownership Interest Jan 1, 1966 50%
Henry Hargrove Individual Corporate DirectorBoard Member Jun 1, 2019
Emma Bell Individual Corporate DirectorBoard Secretary/Treasurer Sep 18, 2018
Corporate DirectorBoard Secretary/Treasurer Sep 18, 2018
Jennifer Dawne Holmes Individual Corporate OfficerCfo Oct 26, 2009
W-2 Managing EmployeeCfo Oct 26, 2009
Operational/Managerial ControlCfo Oct 26, 2009
Corporate DirectorCfo Oct 26, 2009
W-2 Managing EmployeeW-2 Managing Employee Oct 26, 2009
Tracy Shelton Individual Corporate DirectorBoard Member Oct 7, 2019

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
After Hours ClinicGreenwood, MS, CCN 258555 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jun 10, 2009
Jun 10, 2009
Itta Bena ClinicItta Bena, MS, CCN 253418 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 23, 2006

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 105

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 105

Affiliated clinicians 161

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

View all 161

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785456000000",
    "number": "1699714717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 CLINTON CENTER DR STE 4100",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565610",
            "telephone_number": "601-815-6381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 RIVER RD",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389304030",
            "telephone_number": "662-459-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-05",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A",
        "authorized_official_last_name": "MARTINDALE",
        "authorized_official_first_name": "KIMBERLEY",
        "authorized_official_middle_name": "WRENN",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "601-815-6381"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MS",
            "license": "11065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UMMC Greenwood Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "State of Mississippi - University of Mississippi Medical Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Greenwood, MS

Sources for this page

Verify at the official NPI Registry.