Public record

CMS Home Health Agency All Owners

Associate id: 9931010600 · 16 matching records

Enrollment id
O20071120000184
Associate id
9931010600
Organization name
NORTH MISSISSIPPI MEDICAL CENTER, INC.
Associate id - owner
0042309643
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2021-10-01
First name - owner
BARRY
Middle name - owner
D
Last name - owner
BERTOLET
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20071120000184
Associate id
9931010600
Organization name
NORTH MISSISSIPPI MEDICAL CENTER, INC.
Associate id - owner
0446518419
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2021-10-01
First name - owner
CALUDE
Last name - owner
WAYCASTER
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20071120000184
Associate id
9931010600
Organization name
NORTH MISSISSIPPI MEDICAL CENTER, INC.
Associate id - owner
0749202984
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1966-07-01
First name - owner
WILLIAM
Middle name - owner
H
Last name - owner
MILAM
Enrollment id
O20071120000184
Associate id
9931010600
Organization name
NORTH MISSISSIPPI MEDICAL CENTER, INC.
Associate id - owner
3274570858
Type - owner
O
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
1966-07-01
Organization name - owner
NORTH MISSISSIPPI HEALTH SERVICES INC
Doing business as name - owner
DERMATOLOGY CONSULTANTS
Address line 1 - owner
830 SOUTH GLOSTER
City - owner
TUPELO
State - owner
MS
Zip code - owner
38801
Corporation - owner
N
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Enrollment id
O20071120000184
Associate id
9931010600
Organization name
NORTH MISSISSIPPI MEDICAL CENTER, INC.
Associate id - owner
3375445000
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
1966-07-01
First name - owner
BRUCE
Middle name - owner
J
Last name - owner
TOPPIN
Enrollment id
O20071120000184
Associate id
9931010600
Organization name
NORTH MISSISSIPPI MEDICAL CENTER, INC.
Associate id - owner
3870515000
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2021-10-01
First name - owner
LEWIS
Last name - owner
WHITFIELD
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20071120000184
Associate id
9931010600
Organization name
NORTH MISSISSIPPI MEDICAL CENTER, INC.
Associate id - owner
4486953254
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2017-04-04
First name - owner
SHARON
Middle name - owner
D
Last name - owner
NOBLES
Title - owner
TREASURER
Enrollment id
O20071120000184
Associate id
9931010600
Organization name
NORTH MISSISSIPPI MEDICAL CENTER, INC.
Associate id - owner
5395130041
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2021-10-01
First name - owner
SAMUEL
Middle name - owner
JEFFERY
Last name - owner
SLIMAN
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20071120000184
Associate id
9931010600
Organization name
NORTH MISSISSIPPI MEDICAL CENTER, INC.
Associate id - owner
5890732473
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2021-10-01
First name - owner
SAMUEL
Middle name - owner
C
Last name - owner
PACE
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20071120000184
Associate id
9931010600
Organization name
NORTH MISSISSIPPI MEDICAL CENTER, INC.
Associate id - owner
5890753206
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2014-02-01
First name - owner
MICHAEL
Middle name - owner
S
Last name - owner
SPEES
Title - owner
CEO
Enrollment id
O20071120000184
Associate id
9931010600
Organization name
NORTH MISSISSIPPI MEDICAL CENTER, INC.
Associate id - owner
6800154873
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2021-10-01
First name - owner
JOHN
Last name - owner
WHEELER
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20071120000184
Associate id
9931010600
Organization name
NORTH MISSISSIPPI MEDICAL CENTER, INC.
Associate id - owner
7012302763
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2021-10-01
First name - owner
GARY
Middle name - owner
LYNN
Last name - owner
SPARKMAN
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20071120000184
Associate id
9931010600
Organization name
NORTH MISSISSIPPI MEDICAL CENTER, INC.
Associate id - owner
7911095310
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1966-07-01
First name - owner
CHRIS
Last name - owner
ROGERS
Enrollment id
O20071120000184
Associate id
9931010600
Organization name
NORTH MISSISSIPPI MEDICAL CENTER, INC.
Associate id - owner
8224396288
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2021-10-01
First name - owner
DAVID
Last name - owner
COPENHAVER
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20071120000184
Associate id
9931010600
Organization name
NORTH MISSISSIPPI MEDICAL CENTER, INC.
Associate id - owner
8527147487
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2021-10-01
First name - owner
CHESTER
Middle name - owner
K
Last name - owner
WHITE
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20071120000184
Associate id
9931010600
Organization name
NORTH MISSISSIPPI MEDICAL CENTER, INC.
Associate id - owner
8628063658
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2015-03-30
First name - owner
DAVID
Last name - owner
WILSON
Title - owner
ADMINISTRATOR

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