NPIMap

Organization Active NPI

Neshoba County General Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Philadelphia, MS
National Provider Identifier
1750416459
Registry record updated Oct 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
11 227 Issued in 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
Last updated
Oct 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2009

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

Authorized official

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

Specialties & licenses 1

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

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

Medicare participation

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

Enrollment records 2

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

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1750416459. Details of each certification follow.

Hospital certification: CCN 25U043

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

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).

National Provider Directory

National Provider Directory
Tax ID family
Neshoba Co Hosp Profee16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

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
Gary L McCall Individual Corporate DirectorCeo Jan 1, 2016 100%
Corporate DirectorChief 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 OfficerCfo Jan 1, 2016
Corporate DirectorCfo Jan 1, 2016 100%
W-2 Managing EmployeeCfo Jan 1, 2016
Corporate DirectorChief Financial Officer Oct 1, 2013
Marshall Posey Individual Corporate OfficerBoard Chairman Jan 1, 2012
Jo Helen Daly Individual Corporate OfficerBoard Member Jan 1, 1996
Ruby Brazzle Individual Corporate OfficerBoard Member Aug 1, 2011
Oliver Jolly Individual Corporate OfficerBoard Secretary Jan 1, 1998
Dale Joyner Individual Corporate OfficerBoard Vice Chairmain Jan 1, 2020
Wesley Parker Individual W-2 Managing EmployeeCredentialing Coordinator Apr 22, 2002

Owners & managing parties with NPI records 6

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

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 UnitPhiladelphia, MS, CCN 25S043 Hospital Operational/Managerial Control May 1, 2009
Neshoba County General HospitalPhiladelphia, MS, CCN 251340 Hospital Operational/Managerial Control Jan 1, 2025
Neshoba County General Hospital-Nursing HomePhiladelphia, 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 AssociatesPhiladelphia, MS, CCN 258559 Rural health clinic Other (100%) Apr 1, 2012

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 4

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": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255651200000",
    "number": "1750416459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 HOLLAND AVE",
            "address_2": "P.O. BOX 648",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502161",
            "telephone_number": "601-663-1200",
            "fax_number": "601-663-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 HOLLAND AVE",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502161",
            "telephone_number": "601-663-1200",
            "fax_number": "601-663-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NESHOBA COUNTY GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2009-10-16",
        "status": "A",
        "authorized_official_last_name": "BRUMMOND",
        "authorized_official_first_name": "CAL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "601-663-1367",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "MS",
            "license": "11 227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, MS

Sources for this page

Verify at the official NPI Registry.