Baptist Memorial Hospital Union County, Inc.
Organization Active NPI General Acute Care Hospital · New Albany, MS
NPI 1780648352 · NPPES record last updated Sep 30, 2020
Key facts
- NPI
- 1780648352
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- License
- 16239 (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
- Organization subpart
- Yes
- Parent organization (as reported)
- BAPTIST MEMORIAL HEALTH CARE CORP.
Authorized official
- Name
- Gregory M Duckett
- Title
- Sr VP/ Clo
- Phone
- (901) 227-5233
Parent organization (reported in NPPES) 1
Owners & managing parties with NPI records 1
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 4
Related certifications (CCN) 1
Facilities with the same owner 47
Practitioners 111
-
John C. Allen, M.D.
-
Syed S Azmi, MD
-
Thomas Ford Barkley, M.D.
-
Latia Monanette Butts, CFNP
-
James Forest Call Jr., FNP-C
-
Kirk Cooper Eddleman, M.D.
-
Paul Farabaugh, MD
-
Lauren Parker Hayward, M.D.
-
Jonathan Kalish, MD
-
Sohail A Minhas, MD
-
Muhammad M Mirza, MD
-
Suhail M Obaji, M.D.
-
Katelynn Pannell, NP
-
Micaela Delashmit Perkins, BSN, RN, MSN, NP-C
-
Jon T Posey, MD
-
Sandra Allison Russell, NP-C
-
Michael Shane Scott, D.O.
Affiliated clinicians 348
-
Jeremy Caleb Adams, M.D.
-
Mohammed Hussein Al-Wadei, MPH., PHD., MD.
-
John C. Allen, M.D.
-
Cassie Allred, PA-C
-
Syed S Azmi, MD
-
Amanda H Bagwell, CRNA
-
Michael Brian Bagwell, D.O.
-
Allison Miller Bailey, CFNP
-
James Bailey, CRNA, DNP
-
Thomas Ford Barkley, M.D.
-
Leody Caibigan Bautista, M.D.
-
Jeanne R Benson, CFNP
-
Mikul Bhikha, MD
-
Heather Hudson Bishop, FNP-C
-
Michael Ted Boler Jr., D.O.
Medicare Care Compare: Hospital
- Listed as
- Baptist Memorial Hospital Union County
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Other
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MS
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
- Corporation · Non-profit
- Incorporated
- Mar 22, 1989 in MS
- Enrollment address
- 200 State Highway 30 W
New Albany, MS 38652-3112 - Hospital subgroups
- General, Acute care
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| Jason M Little |
Corporate Officer |
Jan 14, 2013 | |
| John Stanford |
Corporate Director |
Apr 24, 2008 | |
| Gary C Anderson |
Corporate Officer |
Jan 1, 2025 | |
| Arthur Maples |
Corporate Director |
Dec 14, 2020 | |
| Rusty Berryhill |
Corporate Officer |
Jan 1, 2025 | |
| Baptist Memorial Hospital Union County, Inc. |
5% Or Greater Direct Ownership Interest | Mar 22, 1989 | 100% |
| Colt Doom |
Corporate Director |
May 1, 2023 | |
| Gregory M Duckett |
Corporate Officer |
Jan 1, 2000 | |
| Baptist Memorial Health Care Corporation |
5% Or Greater Indirect Ownership Interest | Mar 22, 1989 | 100% |
| Anna Bishop |
W-2 Managing Employee |
May 1, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- BMH Union County DME
- Part of
- Baptist Memorial Health Care Corp
Locations
119 City Market Dr
Ste C
Saltillo, MS 38866
Phone (662) 253-8243
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 16239 | MS | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000019377 | Other | MS | MS BC PRO FEE PROVIDER NU |
| 00020010 | Medicaid | MS | |
| 000020377 | Other | MS | BLUE CROSS PROVIDER NUMBE |
| 00050003 | Medicaid | MS | |
| 09013177 | Medicaid | MS |
Other providers in New Albany, MS
- Baptist Memorial Health Services Inc of Mississippi
- Baptist Memorial Health Services Inc of Mississippi
- Baptist Memorial Health Services, Inc. of Mississippi
- Baptist Memorial Hospital Union County, Inc.
- Baptist Memorial Hospital Union County, Inc.
- Baptist Memorial Hospital Union County, Inc.
- Baptist Memorial Hospital Union County, Inc.
- Thomas Ford Barkley
- Jennifer Olivia Barnes
- Robert E Barnett
All providers in New Albany, MS · General Acute Care Hospital in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.