S E LACKEY MEMORIAL HOSPITAL
NPI 1306909734
General Acute Care Hospital - Critical Access in Forest, MS

Q: What is the provider's specialty?

The provider's specialty is General Acute Care Hospital with taxonomy code 282NC0060X and a focus in Critical Access.

Active since December 18, 2006CLIA 25D0317513 · Certificate of Compliance

330 N BROAD ST, FOREST, MS 39074(601) 469-4151(601) 469-3681 Get Directions Write a Review

NPPES record last updated: July 26, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 26, 2023, May 26, 2020 (2 updates tracked since 2020).

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About S E Lackey Memorial Hospital NPPES

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

S E LACKEY MEMORIAL HOSPITAL (NPI 1306909734) is a healthcare organization registered as a critical access in Forest, Mississippi and active in the NPI registry since December 2006. The organization holds a CLIA Certificate of Compliance certificate valid through December 1, 2026, maintains a secondary practice location in Forest, and lists John P Lee, Chairman Of The Board, as its authorized official.

NPPES Registry Identity

NPI1306909734

Entity TypeOrganization

Primary Taxonomy282NC0060X

Legal Business NameINDEPENDENT HEALTHCARE MANAGEMENT, INC.

Location Address330 N BROAD STForest, MS 39074-3508

Mailing AddressPo Box DForest, MS 39074-0558 · (601) 469-4151

Phone(601) 469-4151

Fax(601) 469-3681

Organization SubpartNo

Authorized OfficialJohn P LeeChairman Of The Board · (601) 469-4771

Enumeration DateDecember 18, 2006

Last NPPES UpdateJuly 26, 20232 updates tracked since enumeration

NPPES CertifiedJuly 26, 2023

✔ NPI 1306909734 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral Acute Care Hospital · Critical AccessHospitals

Taxonomy Code282NC0060X

License✔ Licensed in MS · 13-033

330 N BROAD ST, Forest, MS 39074

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Other Names 1

Doing Business AsS E Lackey Memorial Hospital

Secondary Practice Location 1

Location 1505 Airport Rd Ste FForest, MS 39074-4033 · Phone (601) 333-0947

Other Identifiers 3

Medicaid00220324MS

Medicaid09013565MS

Medicaid09013844MS

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

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 Compliance 25D0317513

S E Lackey Memorial Hospital · Forest, MS

Active · expires Dec 1, 2026

CLIA Number25D0317513

Laboratory TypeHospital

Certificate Effective DateDecember 2, 2024

Certificate Expiration DateDecember 1, 2026

Laboratory DirectorDr. Abram T. Coppage IV

Laboratory Phone(601) 469-4151

Laboratory LocationS E Lackey Memorial Hospital330 N Broad St, Forest, MS 39074

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Hospital Quality Ratings CMS Care Compare

Quality and patient-experience ratings for S E Lackey Memorial Hospital (CMS certification number 251300), from CMS Care Compare.

S E Lackey Memorial Hospital

Critical Access Hospitals · Forest, MS

OwnershipVoluntary non-profit - Private

CMS Certification Number251300

Location330 N Broad StreetForest, MS 39074 · Scott County · (601) 469-4151

Emergency services Meaningful use of EHRs

Complications & Deaths 5

Death rate for stroke patients

Cases too small to report

Death rate for pneumonia patients

Cases too small to report

Death rate for heart failure patients

Cases too small to report

Death rate for COPD patients

Cases too small to report

Death rate for heart attack patients

Cases too small to report

Infections 1

Clostridium Difficile (C.Diff)

1 observed case · 1.1 predicted · 3,220 patient days

0.909 No different than national

Unplanned Hospital Visits 11

Rate of readmission after discharge from hospital (hospital-wide)

80 No different than national

Pneumonia (PN) 30-Day Readmission Rate

Cases too small to report

Heart failure (HF) 30-Day Readmission Rate

Cases too small to report

Rate of readmission for chronic obstructive pulmonary disease (COPD) patients

Cases too small to report

Acute Myocardial Infarction (AMI) 30-Day Readmission Rate

Cases too small to report

Rate of emergency department (ED) visits for patients receiving outpatient chemotherapy

Cases too small to report

Timely & Effective Care 8

Left before being seen

Average (median) time patients spent in the emergency department before leaving from the visit A lower number of minutes is better

130 minutes

Healthcare workers given influenza vaccination

14%

Admit Decision Time to ED Departure Time for Admitted Patients - non psychiatric/mental health disorders

29 minutes

Emergency department volume

Low

Venous Thromboembolism Prophylaxis

56%

Other Providers at the Same Location NPPES 12

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

INDEPENDENT HEALTHCARE MANAGEMENT, INC

General Acute Care Hospital (Critical Access)