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Tallahatchie General Hospital

Organization Active NPI Critical Access Hospital · Charleston, MS

NPI 1992706303 · NPPES record last updated Dec 16, 2024

Key facts

NPI
1992706303
Entity type
Organization (NPI type 2)
Primary specialty
Critical Access Hospital 282NC0060X
License
11-211 (MS)
Legal business name
TALLAHATCHIE GENERAL HOSPITAL
Practice address
141 Dr. T T Lewis Circle
Charleston, MS 38921-2236
Phone
(662) 647-5535
Fax
(662) 647-3677
NPI assigned
Aug 9, 2005
Organization subpart
No

Authorized official

Name
Barbara Crocker
Title
Billing Manager
Phone
(662) 625-7176

Owned or controlled facilities with NPI records 3

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

Other NPIs on the same Medicare enrollment 5

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

Other NPIs with the same Medicare PAC ID 6

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

Corporate family (same tax ID) 7

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

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

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 4

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MS

Hospital certification: CCN 25Z304

Legal name
TALLAHATCHIE GENERAL HOSPITAL
Organization structure
Other · Non-profit
Enrollment address
141 Dr. T. T. Lewis Circle
Charleston, MS 38921-2236
Other Hospital Practice Location

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Charles Weissinger
Individual 		Corporate Officer
Cfo		 Jan 23, 2024
W-2 Managing Employee Jan 23, 2024
Frank McRae
Individual 		Corporate Officer
Coo		 Aug 1, 2016
Donald Blackwood
Individual 		Corporate Officer
Ceo		 Feb 22, 2011
W-2 Managing Employee Feb 22, 2011

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Tallahatchie General Hospital
Charleston, MS · CCN 251304		 Hospital 5% Or Greater Direct Ownership Interest Feb 1, 2002
Holcomb Clinic
Grenada, MS · CCN 258601		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2015
Tutwiler Clinic
Tutwiler, MS · CCN 258620		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2016

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040303000646 MS Part B Supplier - Clinic/Group Practice 1052208097 Receives reassigned benefits from 25 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Charleston, MS; Grenada, MS; Tutwiler, MS
O20080618000399 MS Part a Provider - Critical Access Hospital 1052208097 Practice locations: Charleston, MS

National Provider Directory

Tax ID family
Tallahatchie Gen Hosp (8 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 11-211 MS
Critical Access Hospital 282NC0060X 11-211 MS Yes

Addresses

Primary practice location

141 Dr. T T Lewis Circle
Charleston, MS 38921-2236

Mailing address

PO Box 230
141 Dr. TT Lewis Circle
Charleston, MS 38921-0240
Phone (662) 647-5535

Other providers in Charleston, MS

All providers in Charleston, MS · Critical Access Hospital in Mississippi

Sources for this page

Verify at the official NPI Registry.