NPIMap

Organization Active NPI

Rush Medical Foundation

Doing business as Ochsner Health Center- North Meridian

  • Rural Health Clinic/Center
  • Meridian, MS
National Provider Identifier
1891393435
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
RUSH MEDICAL FOUNDATION
Doing business as
Ochsner Health Center- North Meridian
Practice address
2800 N Hills St
Meridian, MS 39305-2643
Phone
(601) 484-9906
Fax
(601) 484-6704
NPI assigned
Oct 15, 2020
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 2

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

Addresses

Primary practice location

2800 N Hills St
Meridian, MS 39305-2643

Mailing address

PO Box 5208
Meridian, MS 39302-5208
Phone (601) 703-9393

Other identifiers 1

IdentifierTypeStateIssuer
000586260MedicaidMS

Other names 1

  • Ochsner Health Center- North Meridian 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
O20031210000541 MS Part B Supplier - Clinic/Group Practice 2567368541 Receives reassigned benefits from 96 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Meridian, MS; Quitman, MS
O20201124000107 MS Part A Provider - Rural Health Clinic 2567368541 Practice locations: Meridian, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891393435. Details of each certification follow.

Rural health clinic certification: CCN 258651

Legal name
RUSH MEDICAL FOUNDATION
Doing business as
OCHSNER HEALTH CENTER-NORTH MERIDIAN
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 6, 2021
Last certification
Jan 6, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
2800 N Hills St
Meridian, MS 39305-2643
Related CCNs
251316

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

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 6

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D0687132Ochsner Health Center - North Meridian2800 North Hills St, Meridian, MS 39305Certificate of waiverJun 10, 2027

National Provider Directory

National Provider Directory
Tax ID family
Rush Rural Med GRP LVNG3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Member of 1

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

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 DirectorMember of Governing Board Jul 1, 2022
Operational/Managerial ControlMember of Governing Board Jul 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 DirectorMember of Governing Board Jul 1, 2022
Operational/Managerial ControlMember of Governing Board Jul 1, 2022
Kawanda C Johnson Individual W-2 Managing EmployeeAdminstrator Jan 1, 2024
Operational/Managerial ControlAdminstrator Jan 1, 2024
James M Molloy Individual Corporate OfficerExecutive VP, Cfo, Treasurer Jan 1, 2024
W-2 Managing EmployeeExecutive VP, Cfo Treasurer 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 OfficerRegional Chief Executive Officer Jul 1, 2022
W-2 Managing EmployeeRegional Chief Executive Officer Jul 1, 2022
Operational/Managerial ControlRegional Chief Executive Officer Jul 1, 2022
Rush Health Systems Inc Organization, Meridian, MS Non-profit, Chain home office, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 1, 2022 100%
Operational/Managerial Control Jan 1, 2021
David L Butler Individual Corporate OfficerCfo, Rush Health Systems Jul 1, 2022
W-2 Managing EmployeeCfo, Rush Health Systems Jul 1, 2022
Operational/Managerial ControlCfo, Rush Health Systems 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.

All facility ownership & control disclosures 7

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

FacilityTypeRoleSince
Ochsner Scott RegionalMorton, MS, CCN 251323 Hospital 5% Or Greater Mortgage Interest (100%) Jan 1, 2020
Ochsner Rush Medical CenterMeridian, MS, CCN 250069 Hospital 5% Or Greater Direct Ownership Interest Dec 15, 1966
Ochsner Stennis HospitalDe Kalb, MS, CCN 251335 Hospital 5% Or Greater Mortgage Interest Jan 1, 2020
Ochsner Stennis Hospital Swing BedDe Kalb, MS, CCN 25Z335 Hospital 5% Or Greater Mortgage Interest (100%) Jan 1, 2020
Ochsner Choctaw GeneralButler, AL, CCN 011304 Hospital 5% Or Greater Mortgage Interest (100%) Jan 1, 2020
Ochsner Laird HospitalUnion, MS, CCN 251322 Hospital 5% Or Greater Mortgage Interest (100%) Jan 1, 2020
Ochsner Watkins HospitalQuitman, MS, CCN 251316 Hospital 5% Or Greater Mortgage Interest (100%) Jan 1, 2020

Owned or controlled facilities with NPI records 7

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

Facilities with the same owner 75

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

  • Kemper Cah, Inc

    dba Ochsner Health Center-Hwy 39

    • Rural Health Clinic/Center
    • Meridian, MS
    • NPI 1275879314

    Ochsner Clinic Foundation, Rush Health Systems Inc

    CMS ownership
  • Kemper Cah, Inc.

    dba Ochsner Stennis Hospital Swing Bed

    • Medicare Defined Swing Bed Hospital Unit
    • De Kalb, MS
    • NPI 1518260322

    Ochsner Clinic Foundation, Rush Health Systems Inc

    CMS ownership
  • Kemper Cah, Inc.

    dba Ochsner Stennis Hospital

    • Critical Access Hospital
    • De Kalb, MS
    • NPI 1679875645

    Ochsner Clinic Foundation, Rush Health Systems Inc

    CMS ownership
  • Kemper Cah, Inc.

    dba Ochsner Health Center-Dekalb

    • Rural Health Clinic/Center
    • De Kalb, MS
    • NPI 1912348616

    Ochsner Clinic Foundation, Rush Health Systems Inc

    CMS ownership
  • Kemper, Cah, Inc.

    dba Ochsner Health Center-Marion

    • Rural Health Clinic/Center
    • Marion, MS
    • NPI 1669812962

    Rush Health Systems Inc

    CMS ownership
  • Laird Hospital, Inc

    dba Ochsner Health Center- Collinsville

    • Rural Health Clinic/Center
    • Collinsville, MS
    • NPI 1073959375

    Ochsner Clinic Foundation, Rush Health Systems Inc

    CMS ownership
  • Laird Hospital, Inc.

    dba Ochsner Laird Hospital Swing Bed

    • Medicare Defined Swing Bed Hospital Unit
    • Union, MS
    • NPI 1033176276

    Ochsner Clinic Foundation, Rush Health Systems Inc

    CMS ownership
  • Laird Hospital, Inc.

    dba Ochsner Health Center- Decatur

    • Rural Health Clinic/Center
    • Decatur, MS
    • NPI 1033460878

    Ochsner Clinic Foundation, Rush Health Systems Inc

    CMS ownership
  • Laird Hospital, Inc.

    dba Ochsner Childrens Health Center

    • Rural Health Clinic/Center
    • Meridian, MS
    • NPI 1114330347

    Ochsner Clinic Foundation, Rush Health Systems Inc

    CMS ownership
  • Laird Hospital, Inc.

    dba Ochsner Health Center- Newton

    • Rural Health Clinic/Center
    • Newton, MS
    • NPI 1194323170

    Ochsner Clinic Foundation, Rush Health Systems Inc

    CMS ownership
  • Laird Hospital, Inc.

    dba Ochsner Health Center- Philadelphia

    • Rural Health Clinic/Center
    • Philadelphia, MS
    • NPI 1275873572

    Ochsner Clinic Foundation, Rush Health Systems Inc

    CMS ownership
  • Laird Hospital, Inc.

    dba Ochsner Laird Hospital

    • Critical Access Hospital
    • Union, MS
    • NPI 1518924752

    Ochsner Clinic Foundation, Rush Health Systems Inc

    CMS ownership
View all 75

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682467200000",
    "number": "1891393435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5208",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393025208",
            "telephone_number": "601-703-9393",
            "fax_number": "601-703-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N HILLS ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393052643",
            "telephone_number": "601-484-9906",
            "fax_number": "601-484-6704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSH MEDICAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-15",
        "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": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000586260",
            "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- North Meridian",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.