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BAPTIST MEMORIAL HOSPITAL DESOTO
NPI 1033155783
Specialist/Technologist - Athletic Trainer in Southaven, MS

Active since June 21, 2006CLIA 25D0316619 · Accreditation
7601 SOUTHCREST PKWY, SOUTHAVEN, MS 38671(662) 349-4000 Get Directions Write a Review

NPPES record last updated: October 1, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 1, 2020, Aug 22, 2020 (2 updates tracked since 2020).

About Baptist Memorial Hospital Desoto NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BAPTIST MEMORIAL HOSPITAL DESOTO (NPI 1033155783) is a healthcare organization registered as an athletic trainer in Southaven, Mississippi and active in the NPI registry since June 2006. The organization holds an CLIA Accreditation certificate valid through November 30, 2027 and lists Gregory M Duckett, Sr Vp/ Clo, as its authorized official.

NPPES Registry Identity

NPI1033155783
Entity TypeOrganization
Primary Taxonomy2255A2300X
Legal Business NameBAPTIST MEMORIAL HOSPITAL DESOTO
Location Address7601 SOUTHCREST PKWYSouthaven, MS 38671-4739
Mailing Address350 N Humphreys BlvdMemphis, TN 38120-2177 · (901) 877-6713
Phone(662) 349-4000
Organization SubpartYesParent: Baptist Memorial Health Care Corp.
Authorized OfficialGregory M DuckettSr Vp/ Clo · (901) 227-5233
Enumeration DateJune 21, 2006
Last NPPES UpdateOctober 1, 20202 updates tracked since enumeration
NPPES CertifiedOctober 1, 2020
✔ NPI 1033155783 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist · Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2255A2300X
License✔ Licensed in MS · AT0300
Definition
Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.
7601 SOUTHCREST PKWY, Southaven, MS 38671
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 25D0316619

Baptist Memorial Hospital · Southaven, MS
Active · expires Nov 30, 2027
CLIA Number25D0316619
Laboratory TypeHospital
Certificate Effective DateDecember 1, 2025
Certificate Expiration DateNovember 30, 2027
Laboratory DirectorDr. Charles T. Beavers
Laboratory Phone(662) 349-4011
Laboratory LocationBaptist Memorial Hospital7601 Southcrest Pkwy, Southaven, MS 38671
CLIA data matches this NPI record on: Address Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MID-SOUTH ANESTHESIA CONSULTANTS, PLLC
Specialist
7601 SOUTHCREST PKWY
SOUTHAVEN, MS 38671
Desoto County (334) 386-2053
SAIF M TAHSIN MD
Family Medicine
7601 SOUTHCREST PKWY
SOUTHAVEN, MS 38671
Desoto County (662) 772-2980
SHAN SHAH MD
Internal Medicine
7601 SOUTHCREST PKWY
SOUTHAVEN, MS 38671
Desoto County (662) 772-2980
KAYLA LAVELLE SWEETEN MD
Student in an Organized Health Care Education/Training Program
7601 SOUTHCREST PKWY
SOUTHAVEN, MS 38671
Desoto County (662) 772-4696
DYLAN COLLINS GOOLSBY FNP
Nurse Practitioner (Family)
7601 SOUTHCREST PKWY
SOUTHAVEN, MS 38671
Desoto County (662) 772-4000
JONATHAN ANDREW MARTINEZ MD
Student in an Organized Health Care Education/Training Program
7601 SOUTHCREST PKWY
SOUTHAVEN, MS 38671
Desoto County (662) 772-3607
PRITI PRAKASH EZHUVATHRA MD
Student in an Organized Health Care Education/Training Program
7601 SOUTHCREST PKWY
SOUTHAVEN, MS 38671
Desoto County (662) 772-3607
JAZMINE CAMPBELL
Student in an Organized Health Care Education/Training Program
7601 SOUTHCREST PKWY
SOUTHAVEN, MS 38671
Desoto County (662) 772-3607

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Baptist Memorial Hospital Desoto's NPI number?

The NPI number for Baptist Memorial Hospital Desoto is 1033155783. It was assigned to this organization in the NPPES registry on June 21, 2006.

Where is Baptist Memorial Hospital Desoto located?

Baptist Memorial Hospital Desoto is located at 7601 Southcrest Pkwy, Southaven, MS 38671. The listed phone number is (662) 349-4000.

What is Baptist Memorial Hospital Desoto's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, specializing in Athletic Trainer, with taxonomy code 2255A2300X.

Does Baptist Memorial Hospital Desoto hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 25D0316619) is associated with this NPI, valid through November 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Baptist Memorial Hospital Desoto was last updated on October 1, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.