NPIMap

Organization Active NPI

Forrest County General Hospital

Doing business as Highland Pediatric and Primary Care RHC

  • Family Medicine Physician
  • Picayune, MS
National Provider Identifier
1922574425
Registry record updated Apr 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FORREST COUNTY GENERAL HOSPITAL
Doing business as
Highland Pediatric and Primary Care RHC
Practice address
146 Highland Pkwy
Picayune, MS 39466-5575
Phone
(601) 358-9765
Fax
(601) 358-9929
NPI assigned
Oct 23, 2018
Last updated
Apr 24, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
FORREST COUNTY GENERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 24, 2020

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

Authorized official

Name
Mr. Ben Hester
Title
Cfo
Phone
(601) 288-4225

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Pediatrics Physician 208000000X NU

Addresses

Primary practice location

146 Highland Pkwy
Picayune, MS 39466-5575

Mailing address

125 S 28TH Ave Ste 326
Hattiesburg, MS 39401-7152

Other names 1

  • Highland Pediatric and Primary Care RHC Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040624001351 MS Part B Supplier - Clinic/Group Practice 1052397767 Receives reassigned benefits from 246 practitioners
21 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Prentiss, MS; Poplarville, MS; Hattiesburg, MS; Picayune, MS; Laurel, MS; Columbia, MS
O20190226002055 MS Part A Provider - Rural Health Clinic 1052397767 Practice locations: Picayune, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922574425. Details of each certification follow.

Rural health clinic certification: CCN 258631

Legal name
FORREST COUNTY GENERAL HOSPITAL
Doing business as
HIGHLAND PEDIATRIC AND PRIMARY CARE RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 22, 2019
Last certification
Aug 22, 2019
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
146 Highland Parkway
Picayune, MS 39466-5575
Related CCNs
250117

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

Other NPIs with the same Medicare PAC ID 24

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

View all 24

Other NPIs on the same Medicare enrollment 19

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

View all 19

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
25D2049350Highland Pediatric & Primary Care Rural Health Cli146 Highland Pkwy, Picayune, MS 39466Certificate of waiverMar 21, 2028

National Provider Directory

National Provider Directory
Tax ID family
Forrest Cty Gen Hosp41 organizations share this tax ID, including this one
Part of
Forrest Cty Gen Hosp

Other organizations with this tax ID 40

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

View all 40

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
Forrest County General Hospital Organization, Hattiesburg, MS Non-profit 5% Or Greater Direct Ownership Interest Dec 1, 2018 100%
Operational/Managerial Control Dec 1, 2018
Ben R Hester Individual Corporate OfficerCfo Dec 1, 2018
W-2 Managing EmployeeCfo Dec 1, 2018
Operational/Managerial ControlCfo Dec 1, 2018

Owners & managing parties with NPI records 24

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

View all 24

All facility ownership & control disclosures 16

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

FacilityTypeRoleSince
Highland Community HospitalPicayune, MS, CCN 250117 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 May 1, 2006
May 1, 2006
The Orthopedic InstituteHattiesburg, MS, CCN 250078 Hospital 5% Or Greater Direct Ownership Interest Jul 15, 1952
Marion General HospitalColumbia, MS, CCN 250085 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2012
Marion General HospitalColumbia, MS, CCN 25U085 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2012
Jefferson Davis Community Hospital Swing BedPrentiss, MS, CCN 25Z326 Hospital Operational/Managerial Control (100%) Jul 1, 2011
Pearl River County Hospital and Nursing HomePoplarville, MS, CCN 251333 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Feb 1, 2020
Feb 1, 2020
Pearl River County Hospital Swing BedPoplarville, MS, CCN 25Z333 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Feb 1, 2020
Feb 1, 2020
Jefferson Davis Extended Care FacilityPrentiss, MS, CCN 255050 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2012
Pearl River County Hospital and Nursing HomePoplarville, MS, CCN 255349 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Feb 1, 2020
Feb 1, 2020
Forrest General Home Care of Marion GeneralColumbia, MS, CCN 257089 Home health agency 5% Or Greater Direct Ownership Interest Jan 1, 2012
Jefferson Davis Rural Health ClinicPrentiss, MS, CCN 258523 Rural health clinic 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jul 1, 2011
Jul 1, 2011
Marion County General HospitalColumbia, MS, CCN 258612 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2014
Oct 1, 2007
Forrest County General HospitalPoplarville, MS, CCN 258556 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Feb 1, 2020
Feb 1, 2020
Highland Center for Women's HealthPicayune, MS, CCN 258683 Rural health clinic Operational/Managerial Control Aug 13, 2017
Forrest County General HospitalRichton, MS, CCN 253452 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2022
Highland Family Medicine ClinicPicayune, MS, CCN 258673 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jun 1, 2022
Jun 1, 2022

Owned or controlled facilities with NPI records 16

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

View all 16

Facilities with the same owner 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587686400000",
    "number": "1922574425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S 28TH AVE STE 326",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017152",
            "fax_number": "601-288-4360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 HIGHLAND PKWY",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394665575",
            "telephone_number": "601-358-9765",
            "fax_number": "601-358-9929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORREST COUNTY GENERAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FORREST COUNTY GENERAL HOSPITAL",
        "enumeration_date": "2018-10-23",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A",
        "authorized_official_last_name": "HESTER",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "601-288-4225",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Highland Pediatric and Primary Care RHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Picayune, MS

Sources for this page

Verify at the official NPI Registry.