Organization Active NPI

Laird Hospital, Inc.

Doing business as Ochsner Health Center- Union

  • Rural Health Clinic/Center
  • Union, MS
National Provider Identifier
1851643928
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
LAIRD HOSPITAL, INC.
Doing business as
Ochsner Health Center- Union
Practice address
24345 Highway 15
Union, MS 39365-8575
Phone
(601) 774-8211
Fax
(601) 774-8589
NPI assigned
Oct 12, 2012
Last updated
Apr 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Authorized official

Name
Don Larkin Kennedy
Title
Regional Ceo
Phone
(601) 703-9614

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary
Family Nurse Practitioner 363LF0000X
Family Medicine Physician 207Q00000X

Addresses

Primary practice location

24345 Highway 15
Union, MS 39365-8575

Mailing address

Dept. 3023 PO Box 1000
Memphis, TN 38148-3023
Phone (601) 213-3010

Other identifiers 1

IdentifierTypeStateIssuer
009015694MedicaidMS

Other names 1

  • Ochsner Health Center- Union Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050201000304 MS Part B Supplier - Clinic/Group Practice 7214991769 Receives reassigned benefits from 106 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Collinsville, MS; Union, MS; Philadelphia, MS; Meridian, MS; Newton, MS; Decatur, MS
O20130530000564 MS Part A Provider - Rural Health Clinic 7214991769 Practice locations: Union, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851643928. Details of each certification follow.

Rural health clinic certification: CCN 253495

Legal name
LAIRD HOSPITAL, INC.
Doing business as
OCHSNER HEALTH CENTER- UNION
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 16, 2001
Last certification
Oct 14, 2021
Ownership / control type
2B
Most recent change of ownership
Dec 1, 2012 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Nov 3, 2004 in MS
Enrollment address
24345 Highway 15
Union, MS 39365-8575
Related CCNs
251322

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

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

24345 Highway 15
Union, MS 39365
Phone (601) 774-8211

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Johnathan Y Lee Individual Corporate DirectorGoverning Board, Rush Health System Jul 1, 2022
Operational/Managerial ControlGoverning Board, Rush Health System Jul 1, 2022
Michael F Hulefeld Individual Corporate OfficerPresident, Coo Nov 1, 2022
Corporate DirectorPresident, Coo Nov 1, 2022
Operational/Managerial ControlPresident, Coo Nov 1, 2022
Faye Martin Individual Corporate DirectorGoverning Board, Rush Health System Jul 1, 2022
Operational/Managerial ControlGoverning Board, Rush Health System Jul 1, 2022
Alan Gartrell Individual Corporate DirectorGoverning Board, Rush Health System Jul 1, 2022
Operational/Managerial ControlGoverning Board, Rush Health System Jul 1, 2022
Peter C November Individual Corporate OfficerChief Executive Officer Nov 1, 2022
Corporate DirectorChief Executive Officer Nov 1, 2022
Operational/Managerial ControlChief Executive Officer Nov 1, 2022
Heather Davis Individual W-2 Managing Employee Jan 1, 2024
Operational/Managerial Control Jan 1, 2024
James M Molloy Individual Corporate Officer Jan 1, 2024
Darrell Wildman Individual Corporate DirectorGoverning Board, Rush Health System Jul 1, 2022
Operational/Managerial ControlGoverning Board, Rush Health System Jul 1, 2022
Ochsner Clinic Foundation Organization, New Orleans, LA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2022 100%
Operational/Managerial Control Jul 1, 2022
Don L Kennedy Individual Corporate Officer Jul 1, 2022
W-2 Managing EmployeeRegional Chief Executive Officer, R Jul 1, 2022
Operational/Managerial ControlRegional Chief Executive Officer, R Jul 1, 2022
Rush Health Systems Inc Organization, Meridian, MS Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2022 100%
Operational/Managerial Control Dec 1, 2012
David L Butler Individual Corporate OfficerChief Financial Officer, Rush Healt Jul 1, 2022
W-2 Managing EmployeeChief Financial Officer, Rush Healt Jul 1, 2022
Operational/Managerial ControlChief Financial Officer, Rush Healt Jul 1, 2022

Owners & managing parties with NPI records 3

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

Facilities with the same owner 75

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

View all 75

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682467200000",
    "number": "1851643928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT. 3023 PO BOX 1000",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381483023",
            "telephone_number": "601-213-3010",
            "fax_number": "601-213-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24345 HIGHWAY 15",
            "city": "UNION",
            "state": "MS",
            "postal_code": "393658575",
            "telephone_number": "601-774-8211",
            "fax_number": "601-774-8589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAIRD HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-12",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "DON",
        "authorized_official_middle_name": "LARKIN",
        "authorized_official_title_or_position": "REGIONAL CEO",
        "authorized_official_telephone_number": "601-703-9614"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009015694",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Ochsner Health Center- Union",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Union, MS

Sources for this page

Verify at the official NPI Registry.