NPIMap

Organization Active NPI

Baptist Memorial Hospital Union County, Inc.

  • General Acute Care Hospital
  • New Albany, MS
National Provider Identifier
1780648352
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
16239 Issued in MS
Legal business name
BAPTIST MEMORIAL HOSPITAL UNION COUNTY, INC.
Practice address
200 Hwy 30 W
New Albany, MS 38652-3112
Phone
(662) 532-7631
NPI assigned
Apr 12, 2006
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
Gregory M Duckett
Title
Sr VP/ Clo
Phone
(901) 227-5233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 16239 MS Primary

Addresses

Primary practice location

200 Hwy 30 W
New Albany, MS 38652-3112

Mailing address

350 N Humphreys Blvd
Memphis, TN 38120-2177
Phone (662) 532-7631

Other identifiers 5

IdentifierTypeStateIssuer
000019377OtherMSMS BC PRO FEE PROVIDER NU
00020010MedicaidMS
09013177MedicaidMS
000020377OtherMSBLUE CROSS PROVIDER NUMBE
00050003MedicaidMS

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040706000553 MS Part B Supplier - Clinic/Group Practice 4183601305 Receives reassigned benefits from 94 practitioners
1 other NPI on this enrollment
Practice locations: Southaven, MS; Oxford, MS; New Albany, MS; Booneville, MS; Grenada, MS
O20081013000125 MS Part A Provider - Hospital 4183601305 Practice locations: Booneville, MS; Grenada, MS; New Albany, MS; Oxford, MS; Saltillo, MS; Southaven, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780648352. Details of each certification follow.

Hospital certification: CCN 250006

Legal name
BAPTIST MEMORIAL HOSPITAL UNION COUNTY, INC.
Doing business as
BMH - UNION COUNTY
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jun 11, 2015
Beds
153 (141 certified)
Ownership / control type
Other
Most recent change of ownership
Apr 1, 1989 (2 total)
Organization structure
CorporationNon-profit
Incorporated
Mar 22, 1989 in MS
Enrollment address
200 State Highway 30 W
New Albany, MS 38652-3112
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

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

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Baptist Memorial Hospital Union CountyCCN 250006 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Baptist Mem Union Co DM5 organizations share this tax ID, including this one
Part of
Baptist Memorial Health Care Corp

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 10

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 OfficerVP Jan 14, 2013
John Stanford Individual Corporate DirectorBoard Member Apr 24, 2008
Gary C Anderson Individual Corporate OfficerVP Jan 1, 2025
Arthur Maples Individual Corporate DirectorDelegated Official Dec 14, 2020
Rusty Berryhill Individual Corporate OfficerSecretary Jan 1, 2025
Baptist Memorial Hospital Union County, Inc. Organization, New Albany, MS Corporation, Non-profit 5% Or Greater Direct Ownership Interest Mar 22, 1989 100%
Colt Doom Individual Corporate DirectorBoard Member May 1, 2023
Gregory M Duckett Individual Corporate OfficerEvp and Clo Jan 1, 2000
Baptist Memorial Health Care Corporation Organization, Memphis, TN Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Mar 22, 1989 100%
Anna Bishop Individual W-2 Managing EmployeeManaging Employee May 1, 2023

Owners & managing parties with NPI records 1

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

Practitioners 111

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 111

Affiliated clinicians 348

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

View all 348

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601424000000",
    "number": "1780648352",
    "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": "662-532-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HWY 30 W",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386523112",
            "telephone_number": "662-532-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST MEMORIAL HOSPITAL UNION COUNTY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAPTIST MEMORIAL HEALTH CARE CORP.",
        "enumeration_date": "2006-04-12",
        "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"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MS",
            "license": "16239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS BC PRO FEE PROVIDER NU",
            "identifier": "000019377",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00020010",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09013177",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMBE",
            "identifier": "000020377",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00050003",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, MS

Sources for this page

Verify at the official NPI Registry.