S E LACKEY MEMORIAL HOSPITAL
NPI 1306909734
General Acute Care Hospital - Critical Access in Forest, MS
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
Specialties & Licenses
Other Names 1
Secondary Practice Location 1
Other Identifiers 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
S E Lackey Memorial Hospital is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
97Medicare enrollment records show 97 clinicians reassign Medicare billing to S E Lackey Memorial Hospital, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 17 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 13
Nearest to this location (20)
See all 97Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, MSHospital 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, MSComplications & Deaths 5
Infections 1
Unplanned Hospital Visits 11
Timely & Effective Care 8
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 Independent Healthcare Management, Inc.'s NPI number?
The NPI number for Independent Healthcare Management, Inc. is 1306909734. It was assigned to this organization in the NPPES registry on December 18, 2006. The provider is doing business as S E Lackey Memorial Hospital.
Where is Independent Healthcare Management, Inc. located?
Independent Healthcare Management, Inc. is located at 330 N Broad St, Forest, MS 39074. The listed phone number is (601) 469-4151.
What is Independent Healthcare Management, Inc.'s specialty?
The primary specialty registered for this NPI is General Acute Care Hospital, specializing in Critical Access, with taxonomy code 282NC0060X.
Is Independent Healthcare Management, Inc. enrolled in Medicare?
Yes. Independent Healthcare Management, Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Independent Healthcare Management, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 97 clinicians in 13 Medicare specialties reassign their Medicare billing to Independent Healthcare Management, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (39), Emergency Medicine (21) and Certified Registered Nurse Anesthetist (CRNA) (13). Of these, 5 practice at this address and 17 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Independent Healthcare Management, Inc. hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 25D0317513) is associated with this NPI, valid through December 1, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
Is Independent Healthcare Management, Inc. a Medicare-certified hospital?
Yes. S E Lackey Memorial Hospital is a Medicare-certified hospital (Critical Access Hospitals). The hospital provides emergency services.
What insurance does Independent Healthcare Management, Inc. accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 3 other insurers list Independent Healthcare Management, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Independent Healthcare Management, Inc. was last updated on July 26, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# S E Lackey Memorial Hospital · NPI 1306909734
Critical Access organization in Forest, Mississippi. Organization record, active in the CMS NPPES registry since December 18, 2006.
## Identity
- **NPI:** 1306909734 (Entity type: Organization)
- **Enumerated:** December 18, 2006
- **Primary specialty:** General Acute Care Hospital - Critical Access · taxonomy 282NC0060X
- **Legal business name:** Independent Healthcare Management, Inc.
- **Organization subpart:** No
- **Authorized official:** John Lee, CHAIRMAN OF THE BOARD
## Practice location
- **Address:** 330 N BROAD ST, Forest, MS 39074-3508
- **Phone:** (601) 469-4151 · **Fax:** (601) 469-3681
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 97 clinicians in 13 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (39), Emergency Medicine (21), Certified Registered Nurse Anesthetist (CRNA) (13); 5 practice at this address and 17 within 10 miles; [full list](https://npiprofile.com/npi/1306909734/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 26, 2023
- **Other identifiers:** Medicaid 00220324 (MS); Medicaid 09013565 (MS); Medicaid 09013844 (MS)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1306909734) · Data from the CMS NPPES public registry.