BAPTIST MEMORIAL HOSPITAL-DESOTO, INC, (NPI# 1194789818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194789818 |
| Entity Type | Organization |
| Organization Name | BAPTIST MEMORIAL HOSPITAL-DESOTO, INC, |
| Practice Address |
7601 Southcrest Pkwy Southaven MS 38671-4739 |
| Mailing Address |
350 N Humphreys Blvd Memphis TN 38120-2177 |
| Practice Telephone | 6623494000 |
| Mailing Telephone | 6623494000 |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2020-10-01 |
| Authorized Official Name | MR. GREGORY M DUCKETT (SR VP/ CLO) |
| Authorized Official Telephone | 9012275233 |
| Is Organization Subpart | Y |
| Parent Organization Name | BAPTIST MEMORIAL HEALTH CARE CORP. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 13318 | MS | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 250141 | 05 | |
| MS | 00020143 | 05 | |
| AR | 114992105 | 05 |
| Street Address |
7601 SOUTHCREST PKWY |
| City | SOUTHAVEN |
| State | MS |
| Zip Code | 38671-4739 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285637090 | Cunningham Physical Medicine | Physical Medicine & Rehabilitation | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2005-05-24 |
| 1598395501 | Raymond Bennett Caldwell Iv | Physician Assistant | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2020-01-17 |
| 1245871847 | Tammy Q Reed | Nurse Practitioner | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2019-10-04 |
| 1871078436 | Catherine R Stepter | Nurse Practitioner | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-09-30 |
| 1669955423 | Tannisha Monique Loggins | Nurse Practitioner | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-09-07 |
| 1982185609 | Gloria S. Hicks | Nurse Anesthetist, Certified Registered | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-08-22 |
| 1326531229 | John Walker | Registered Nurse | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-06-14 |
| 1750871299 | Alejandro Polania | Physician Assistant | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-05-10 |
| 1528558061 | Deera Warren | Nurse Practitioner | 7601 Southcrest Pkwy, Southaven, MS 38671 | 2018-05-10 |
| 1871083386 | Kenneth A Krzyzkowski | Nurse Practitioner | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-05-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285196196 | Emma Tinsley-bowles Long | Social Worker | 8786 Northcreek Blvd, Bldg 8 Apt 3, Southaven, MS 38671 | 2019-04-01 |
| 1851847586 | Tiffany Lashea Jones | Adult Companion | 8755 Millbranch Road, Southaven, MS 38671 | 2016-09-01 |
| 1538526140 | Desoto Pediatric Extended Care LLC | Skilled Nursing Facility | 750 Stateline Road East, Southhaven, MS 38671 | 2016-01-27 |
| 1073983052 | Tara Burt | Physical Therapist | 7900 Airways Blvd. Building A, Suite 2, Southaven, MS 38671 | 2015-10-02 |
| 1295160463 | Ideal Community Care,llc | In Home Supportive Care | 8869 Centre Str #3, Southaven, MS 38671 | 2013-09-06 |
| 1578995692 | Gregory Charles Eakins Jr. | Optometrist | 338 Goodman Rd West, Southaven, MS 38671 | 2013-07-31 |
| 1295173169 | Erica R. Martin | Social Worker | 975 Swinnea Rdg Ste 3, Southaven, MS 38671 | 2013-06-12 |
| 1386918431 | Freds Stores of Tennessee Inc | Pharmacy | 710 Church Road, Southaven, MS 38671 | 2012-03-06 |
| 1740565613 | Mary Jeanette Scruggs | Pharmacist | 1011 Goodman Rd, Southaven, MS 38671 | 2011-10-11 |
| 1184919268 | First Pharmacy Services 5 | Pharmacy | 5185a Getwell Rd, Southaven, MS 38671 | 2011-06-16 |
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| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679742944 | Adult Neurology Clinic Pllc | General Acute Care Hospital | 401 Southcrest Cir, Suite 210, Southaven, MS 38671-6726 | 2008-02-21 |
| 1679625511 | Baptist Memorial Hospital- Desoto | General Acute Care Hospital | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2007-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184073181 | 81msgs/sgcq | General Acute Care Hospital | 81msgs/sgcq, 301 Fisher St, Rm 5a127, Keesler Afb, MS 39534 | 2016-06-09 |
| 1013396290 | Martin Hillard Mcmullan | General Acute Care Hospital | 2350 Cooper Rd, Flowood, MS 39232-6136 | 2015-05-21 |
| 1750771580 | Genesis Rehab | General Acute Care Hospital | 438 North St, Union, MS 39365-9506 | 2015-02-02 |
| 1003229469 | Robert J Cole | General Acute Care Hospital | 601 Meadowbrook Cir, Amory, MS 38821-1314 | 2014-06-03 |
| 1295151850 | Mary A. Doss | General Acute Care Hospital | 110 Napoleon Dr, Brandon, MS 39047-9004 | 2014-03-06 |
| 1467755744 | Biloxi Regional Medical Center | General Acute Care Hospital | 1104 Homestead Blvd, Gautier, MS 39553-4612 | 2010-12-08 |
| 1528371119 | University Physicians. Pllc | General Acute Care Hospital | 121 Beaufort Cir, Madison, MS 39110-7962 | 2010-07-23 |
| 1306047436 | Alliance Healthcare System | General Acute Care Hospital | 1430 Hwy4-east, Holly Springs, MS 38635 | 2007-05-29 |
| 1518168624 | Alliance Healthcare System | General Acute Care Hospital | 1430 Hwy 4 East, Holly Springs, MS 38635 | 2007-05-29 |
| 1043427206 | Alliance Healthcare System, Inc | General Acute Care Hospital | 1430 Highway 4 E, Holly Springs, MS 38635-2140 | 2007-05-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.