NPIMap

Organization Active NPI

BMC - Attala, LLC

Doing business as Baptist Medical Center - Attala

  • Medicare Defined Swing Bed Hospital Unit
  • Kosciusko, MS
National Provider Identifier
1750769865
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
BMC - ATTALA, LLC
Doing business as
Baptist Medical Center - Attala
Practice address
220 Hwy. 12 West
Kosciusko, MS 39090
Phone
(662) 289-4311
Fax
(662) 290-3302
NPI assigned
May 8, 2015
Last updated
Sep 30, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
BAPTIST MEMORIAL HEALTH CARE CORP.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Authorized official

Name
Mr. Gregory M Duckett
Title
Sr VP/ Clo
Phone
(901) 227-5233

Specialties & licenses 1

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

Addresses

Primary practice location

220 Hwy. 12 West
Kosciusko, MS 39090

Mailing address

350 N Humphreys Blvd
Memphis, TN 38120-2177
Phone (601) 968-1000

Other names 1

  • Baptist Medical Center - Attala Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150828001216 MS Part A Provider - Critical Access Hospital 6204142771 Practice locations: Kosciusko, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750769865. Details of each certification follow.

Hospital certification: CCN 25Z336

Legal name
BMC - ATTALA, LLC
Doing business as
BAPTIST MEDICAL CENTER - ATTALA
Organization structure
LLCNon-profit
Incorporated
Mar 30, 2015 in MS
Enrollment address
220 Highway 12 W
Kosciusko, MS 39090-3208
Opt Extension Site

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).

National Provider Directory

National Provider Directory
Tax ID family
BMC - Attala LLC3 organizations share this tax ID, including this one
Part of
Baptist Memorial Health Care Corp

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Jason M Little Individual Corporate OfficerPresident Dec 16, 2020
Gary C Anderson Individual Corporate DirectorBoard Member Dec 21, 2020
John G Wallace Individual Corporate DirectorBoard Member Dec 16, 2020
Arthur Maples Individual Corporate DirectorDelegated Official Dec 16, 2020
Timothy J Alford Individual Corporate DirectorBoard Member Jun 1, 2015
Leeann Foreman Individual Corporate DirectorBoard Member Dec 16, 2020
Tim L Cook Individual Corporate DirectorBoard Member Jun 1, 2015
Robert Coleman Individual Corporate OfficerCeo Dec 16, 2020
W-2 Managing EmployeeCeo Dec 16, 2020
Milessa Boswell Townsend Individual Corporate DirectorBoard Member Dec 16, 2020
Paul Duane Depriest Individual Corporate OfficerVP Feb 25, 2021
BMC - Attala, LLC Organization, Kosciusko, MS LLC, Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2023 100%
Curtis Turnbow Individual Corporate DirectorBoard Member Dec 16, 2020
Gregory M Duckett Individual Corporate OfficerCorp Sec at Bmhcc May 1, 2017
William Griffin Individual Corporate OfficerEvp Cfo Dec 16, 2020
Mississippi Baptist Health Systems, Inc Organization, Jackson, MS Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2023 100%
Baptist Memorial Health Care Corporation Organization, Memphis, TN Corporation, Non-profit 5% Or Greater Indirect Ownership Interest May 1, 2017 100%

Owners & managing parties with NPI records 5

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

Facilities with the same owner 47

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

View all 47

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Affiliated clinicians 8

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": "1431043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601424000000",
    "number": "1750769865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N HUMPHREYS BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202177",
            "telephone_number": "601-968-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 HWY. 12 WEST",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "39090",
            "telephone_number": "662-289-4311",
            "fax_number": "662-290-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BMC - ATTALA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAPTIST MEMORIAL HEALTH CARE CORP.",
        "enumeration_date": "2015-05-08",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A",
        "authorized_official_last_name": "DUCKETT",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SR VP/ CLO",
        "authorized_official_telephone_number": "901-227-5233",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Medical Center - Attala",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Baptist Medical Center - Attala",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kosciusko, MS

Sources for this page

Verify at the official NPI Registry.