NPIMap

Organization Active NPI

Mississippi Methodist Hospital & Rehabilitation Center, Inc.

Doing business as Methodist Rehab Center

  • General Acute Care Hospital
  • Jackson, MS
National Provider Identifier
1841349792
Registry record updated Nov 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
43-278 Issued in MS
Legal business name
MISSISSIPPI METHODIST HOSPITAL & REHABILITATION CENTER, INC.
Doing business as
Methodist Rehab Center
Practice address
1350 E Woodrow Wilson Ave
Jackson, MS 39216-5112
Phone
(601) 981-2611
NPI assigned
Jan 9, 2007
Last updated
Nov 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2008

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

Authorized official

Name
Gary Armstrong
Title
Executive Vice President
Phone
(601) 981-2611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 43-278 MS Primary

Addresses

Primary practice location

1350 E Woodrow Wilson Ave
Jackson, MS 39216-5112

Mailing address

1350 E Woodrow Wilson Ave
Jackson, MS 39216-5112
Phone (601) 981-2611

Other identifiers 1

IdentifierTypeStateIssuer
00020223MedicaidMS

Other names 1

  • Methodist Rehab Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081117000461 MS Part A Provider - Hospital 8921912270 1 other NPI on this enrollment
Practice locations: Flowood, MS; Tupelo, MS; Starkville, MS; Ridgeland, MS; Oxford, MS; Monroe, LA; Meridian, MS; Jackson, MS…

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1841349792. Details of each certification follow.

Hospital certification: CCN 250152

Legal name
MISSISSIPPI METHODIST HOSPITAL & REHABILITATION CENTER, INC.
Doing business as
METHODIST REHAB CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 2002
Last certification
Apr 3, 2002
Beds
124
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
1350 East Woodrow Wilson
Methodist Rehabilitation Center
Jackson, MS 39216-5112
Other Hospital Practice Location
Hospital subgroups
General, Rehabilitation unit

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

Other NPIs with the same Medicare PAC ID 13

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

View all 13

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Mississippi Methodist Rehab CtrCCN 250152 · All quality measures
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Ms Methodist Rehab Center14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Gary Armstrong Individual Corporate OfficerExec VP Finance Jul 1, 2002
W-2 Managing EmployeeCfo Jul 1, 2002
Renee Morgan Individual W-2 Managing Employee Feb 9, 2023

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Methodist Rehab CenterJackson, MS, CCN 25T152 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1975

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 3

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 162

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

View all 162

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226880000000",
    "number": "1841349792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 E WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165112",
            "telephone_number": "601-981-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 E WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165112",
            "telephone_number": "601-981-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI METHODIST HOSPITAL & REHABILITATION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2008-11-17",
        "status": "A",
        "authorized_official_last_name": "ARMSTRONG",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "601-981-2611"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MS",
            "license": "43-278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00020223",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Methodist Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.