NPIMap

Organization Active NPI

State of Mississippi - University of Mississippi Medical Center

Doing business as Holmes County Hospital and Clinic

  • Medicare Defined Swing Bed Hospital Unit
  • Lexington, MS
National Provider Identifier
1700872173
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Doing business as
Holmes County Hospital and Clinic
Practice address
239 Bowling Green Rd
Lexington, MS 39095-5167
Phone
(662) 834-1321
Fax
(601) 815-6301
NPI assigned
Sep 21, 2005
Last updated
Jun 26, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Authorized official

Name
Mr. William Kennedy
Title
Director of Patient Financial Serv
Phone
(601) 984-4680

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

Addresses

Primary practice location

239 Bowling Green Rd
Lexington, MS 39095-5167

Mailing address

2500 N State St
Jackson, MS 39216-4500
Phone (662) 834-1321

Other names 1

  • Holmes County Hospital and Clinic Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080702000310 MS Part A Provider - Critical Access Hospital 1850293036 Practice locations: Lexington, MS
O20090414000575 MS Part B Supplier - Clinic/Group Practice 1850293036 Receives reassigned benefits from 1,922 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700872173. Details of each certification follow.

Hospital certification: CCN 25Z319

Legal name
STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Doing business as
UNIVERSITY OF MISSISSI MEDICAL CENTER- HOLMES COUNTY
Organization structure
GovernmentNon-profit
Enrollment address
239 Bowling Green Rd
Lexington, MS 39095-5167
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 22

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

View all 22

Other NPIs on the same Medicare enrollment 15

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

View all 15

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

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Jeffrey G Grimsley Individual Corporate OfficerHealth System Cfo May 1, 2015
W-2 Managing Employee May 1, 2015
State of Mississippi-University of Mississippi Medical Center Organization, Jackson, MS Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2004

Owners & managing parties with NPI records 22

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

View all 22

All facility ownership & control disclosures 14

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

FacilityTypeRoleSince
State of Mississippi-University of Mississippi Medical CenterJackson, MS, CCN 250001 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jul 1, 2007
Jul 1, 2007
Holmes County Hospital & ClinicsLexington, MS, CCN 251319 Hospital 5% Or Greater Direct Ownership Interest Oct 1, 2004
Ummc- GrenadaGrenada, MS, CCN 250168 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Feb 21, 2014
Feb 21, 2014
Ummc MadisonCanton, MS, CCN 250038 Hospital 5% Or Greater Direct Ownership Interest (100%) May 1, 2025
Ummc MadisonCanton, MS, CCN 25U038 Hospital 5% Or Greater Direct Ownership Interest (100%) May 1, 2025
Lexington Rural Health ClinicLexington, MS, CCN 253813 Rural health clinic 5% Or Greater Direct Ownership Interest May 23, 2013
West Rural Health ClinicWest, MS, CCN 253812 Rural health clinic 5% Or Greater Direct Ownership Interest May 22, 2013
Ummc- Grenada Women's ServicesGrenada, MS, CCN 258626 Rural health clinic 5% Or Greater Direct Ownership Interest Jan 1, 2014
Holmes County Family Medicine Clinic- VaidenVaiden, MS, CCN 258625 Rural health clinic 5% Or Greater Direct Ownership Interest Oct 1, 2016
Ummc Grenada Specialty PediatricsGrenada, MS, CCN 258627 Rural health clinic 5% Or Greater Direct Ownership Interest Jan 1, 2014
Children's of Mississippi Greenwood ClinicGreenwood, MS, CCN 258682 Rural health clinic 5% Or Greater Direct Ownership Interest Oct 1, 2023
Ummc Greenwood Primary Care ClinicGreenwood, MS, CCN 258679 Rural health clinic 5% Or Greater Direct Ownership Interest Oct 1, 2023
Ummc Greenwood Women's ClinicGreenwood, MS, CCN 258680 Rural health clinic 5% Or Greater Direct Ownership Interest Oct 1, 2023
Ummc Grenada Primary Medicine ClinicGrenada, MS, CCN 258681 Rural health clinic 5% Or Greater Direct Ownership Interest Oct 1, 2023

Owned or controlled facilities with NPI records 15

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

View all 15

Facilities with the same owner 14

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

View all 14

Practitioners & affiliated clinicians

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1700872173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "662-834-1321",
            "fax_number": "601-815-6301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 BOWLING GREEN RD",
            "city": "LEXINGTON",
            "state": "MS",
            "postal_code": "390955167",
            "telephone_number": "662-834-1321",
            "fax_number": "601-815-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-21",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "DIRECTOR OF PATIENT FINANCIAL SERV",
        "authorized_official_telephone_number": "601-984-4680",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holmes County Hospital and Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lexington, MS

Sources for this page

Verify at the official NPI Registry.