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Neshoba County General Hospital

Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Philadelphia, MS

NPI 1750416459 · NPPES record last updated Oct 16, 2009

Key facts

NPI
1750416459
Entity type
Organization (NPI type 2)
Primary specialty
Medicare Defined Swing Bed Hospital Unit 275N00000X
License
11 227 (MS)
Legal business name
NESHOBA COUNTY GENERAL HOSPITAL
Practice address
1001 Holland Ave
Philadelphia, MS 39350-2161
Phone
(601) 663-1200
Fax
(601) 663-1236
NPI assigned
Feb 22, 2007
Organization subpart
No

Authorized official

Name
Mr. Cal Brummond
Title
Cfo
Phone
(601) 663-1367

Owners & managing parties with NPI records 6

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

Owned or controlled facilities with NPI records 4

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

Other NPIs with the same Medicare PAC ID 6

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

Corporate family (same tax ID) 15

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

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

Facilities with the same owner 3

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

Practitioners 31

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

View all 31

Affiliated clinicians 4

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MS

Hospital certification: CCN 25U043

Legal name
NESHOBA COUNTY GENERAL HOSPITAL
Organization structure
Other · Non-profit
Enrollment address
1001 Holland Ave
Philadelphia, MS 39350-2161
Hospital Swing-Bed Unit
Hospital subgroups
Swing-bed approved

Hospital certification: CCN 25Z340

Legal name
NESHOBA COUNTY GENERAL HOSPITAL
Organization structure
Government · Non-profit
Enrollment address
1001 Holland Ave
Philadelphia, MS 39350-2161
Hospital Swing-Bed Unit

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
Gary L McCall
Individual 		Corporate Director
Ceo		 Jan 1, 2016 100%
Corporate Director
Chief Executive Officer		 Apr 23, 2014
Neshoba County General Hospital
Organization · Philadelphia, MS
Medical provider/supplier, Non-profit 		Operational/Managerial Control May 1, 2009 100%
Operational/Managerial Control Jan 1, 2025
Scott McNair
Individual 		Corporate Officer
Cfo		 Jan 1, 2016
Corporate Director
Cfo		 Jan 1, 2016 100%
W-2 Managing Employee
Cfo		 Jan 1, 2016
Corporate Director
Chief Financial Officer		 Oct 1, 2013
Marshall Posey
Individual 		Corporate Officer
Board Chairman		 Jan 1, 2012
Jo Helen Daly
Individual 		Corporate Officer
Board Member		 Jan 1, 1996
Ruby Brazzle
Individual 		Corporate Officer
Board Member		 Aug 1, 2011
Oliver Jolly
Individual 		Corporate Officer
Board Secretary		 Jan 1, 1998
Dale Joyner
Individual 		Corporate Officer
Board Vice Chairmain		 Jan 1, 2020
Wesley Parker
Individual 		W-2 Managing Employee
Credentialing Coordinator		 Apr 22, 2002

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Neshoba County General Hospital Psych Unit
Philadelphia, MS · CCN 25S043		 Hospital Operational/Managerial Control May 1, 2009
Neshoba County General Hospital
Philadelphia, MS · CCN 251340		 Hospital Operational/Managerial Control Jan 1, 2025
Neshoba County General Hospital-Nursing Home
Philadelphia, MS · CCN 255137		 Skilled nursing facility Operational/Managerial Control (100%)
Adp of the SNF
Direct Ownership Interest (100%)		 Oct 22, 2009
Oct 22, 2009
Oct 22, 2009
Neshoba Medical Associates
Philadelphia, MS · CCN 258559		 Rural health clinic Other (100%) Apr 1, 2012

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20090507000123 MS Part a Provider - Hospital 6204738289 Practice locations: Philadelphia, MS
O20250522003616 MS Part a Provider - Critical Access Hospital 6204738289 Practice locations: Philadelphia, MS

National Provider Directory

Tax ID family
Ms Neurodiagnostic Lab (16 organizations share this tax ID)

Locations

1001 Holland Ave
Philadelphia, MS 39350
Phone (601) 663-1200

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 11 227 MS Yes

Addresses

Primary practice location

1001 Holland Ave
Philadelphia, MS 39350-2161

Mailing address

1001 Holland Ave
P.O. Box 648
Philadelphia, MS 39350-2161
Phone (601) 663-1200

Other identifiers

IdentifierTypeStateIssuer
00029181MedicaidMS
000080024OtherMSBLUE CROSS SWING BED

Other providers in Philadelphia, MS

All providers in Philadelphia, MS · Medicare Defined Swing Bed Hospital Unit in Mississippi

Sources for this page

Verify at the official NPI Registry.