NPIMap

Organization Active NPI

North Mississippi Medical Center, Inc.

Doing business as North Mississippi Medical Center Hospice

  • Community Based Hospice Care Agency
  • Tupelo, MS
National Provider Identifier
1982669156
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
001 Issued in MS
Legal business name
NORTH MISSISSIPPI MEDICAL CENTER, INC.
Doing business as
North Mississippi Medical Center Hospice
Practice address
422-B East President Ave
Tupelo, MS 38801-5500
Phone
(662) 377-3612
Fax
(662) 377-7983
NPI assigned
Apr 19, 2006
Last updated
Oct 8, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH MISSISSIPPI MEDICAL CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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

Authorized official

Name
Mr. Joseph A Reppert
Title
Cfo
Phone
(662) 377-3978

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 001 MS Primary

Addresses

Primary practice location

422-B East President Ave
Tupelo, MS 38801-5500

Mailing address

830 S Gloster St
Tupelo, MS 38801-4934
Phone (662) 377-3000

Other identifiers 2

IdentifierTypeStateIssuer
000070614OtherMSBLUE CROSS
00070662MedicaidMS

Other names 1

  • North Mississippi Medical Center Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071120000256 MS Part A Provider - Hospice 9931010600 Practice locations: Tupelo, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982669156. Details of each certification follow.

Hospice certification: CCN 251501

Legal name
NORTH MISSISSIPPI MEDICAL CENTER, INC.
Doing business as
NORTH MS MEDICAL CENTER HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jun 12, 1984
Last certification
Mar 10, 2021
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
Apr 2, 1982 in DE
Enrollment address
422-B East President Ave
Tupelo, MS 38801-5500

Other NPIs with the same Medicare PAC ID 8

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

Care Compare: Hospice

Medicare Care Compare
Listed as
North Mississippi Medical CtrCCN 251501 · All quality measures
Ownership
Non-Profit
Certified
Jun 12, 1984
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Benjamin Groves MD65 organizations share this tax ID, including this one
Part of
Benjamin Groves MD

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Barry D Bertolet Individual Corporate OfficerBoard Member Oct 1, 2021
Calude Waycaster Individual Corporate OfficerBoard Member Oct 1, 2019
North Mississippi Health Services Inc Organization, Tupelo, MS Non-profit 5% Or Greater Direct Ownership Interest Jul 22, 1981
Bruce J Toppin Individual Corporate OfficerSecretary Jan 29, 1996
Lewis Whitfield Individual Corporate OfficerBoard Member Oct 1, 2019
Sharon D Nobles Individual Corporate OfficerTreasurer Apr 4, 2017
Samuel Jeffery Sliman Individual Corporate OfficerBoard Member Oct 1, 2019
Tommy Adams Individual W-2 Managing EmployeeAdministrator Oct 1, 2022
Samuel C Pace Individual Corporate OfficerBoard Member Oct 1, 2019
Michael S Spees Individual Corporate OfficerPresident-Ceo Aug 1, 2015
John Wheeler Individual Corporate OfficerBoard Member Oct 1, 2019
Gary Lynn Sparkman Individual Corporate OfficerBoard Member Oct 1, 2021
David Copenhaver Individual Corporate OfficerBoard Member Oct 1, 2019
Chester K White Individual Corporate OfficerBoard Member Oct 1, 2019

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Baldwyn Nursing FacilityBaldwyn, MS, CCN 255161 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Mar 16, 2009
Mar 16, 2009
Mar 16, 2009
Childrens Clinic - TupeloTupelo, MS, CCN 258551 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Aug 24, 1992

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 33

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

View all 33

Practitioners & affiliated clinicians

Affiliated clinicians 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570492800000",
    "number": "1982669156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014934",
            "telephone_number": "662-377-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422-B EAST PRESIDENT AVE",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388015500",
            "telephone_number": "662-377-3612",
            "fax_number": "662-377-7983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH MISSISSIPPI MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH MISSISSIPPI MEDICAL CENTER, INC.",
        "enumeration_date": "2006-04-19",
        "last_updated": "2019-10-08",
        "status": "A",
        "authorized_official_last_name": "REPPERT",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "662-377-3978",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MS",
            "license": "001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000070614",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00070662",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Mississippi Medical Center Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Mississippi Medical Center Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.