UMMC GRENADA EKG/EEG SERVICES
NPI 1720419583
General Acute Care Hospital in Grenada, MS
About Ummc Grenada Ekg/eeg Services NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
UMMC GRENADA EKG/EEG SERVICES (NPI 1720419583) is a healthcare organization registered as a general acute care hospital in Grenada, Mississippi and active in the NPI registry since December 2013. The organization holds a CLIA Waiver certificate valid through March 20, 2027 and lists Kevin Cook, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ummc Grenada Ekg/eeg Services is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Ummc Grenada Ekg/Eeg Services, which bills Medicare for the services they deliver. Of these, 4 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (4)
Source: 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 Waiver 25D0317204
Ummc - Grenada Women's Health Services · Grenada, MSFrequently 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 State Of Mississippi-University Of Mississippi Medical Center's NPI number?
The NPI number for State Of Mississippi-University Of Mississippi Medical Center is 1720419583. It was assigned to this organization in the NPPES registry on December 4, 2013. The provider is doing business as Ummc Grenada Ekg/Eeg Services.
Where is State Of Mississippi-University Of Mississippi Medical Center located?
State Of Mississippi-University Of Mississippi Medical Center is located at 960 Avent Dr, Grenada, MS 38901. The listed phone number is (662) 227-7000.
What is State Of Mississippi-University Of Mississippi Medical Center's specialty?
The primary specialty registered for this NPI is General Acute Care Hospital with taxonomy code 282N00000X.
Is State Of Mississippi-University Of Mississippi Medical Center enrolled in Medicare?
Yes. State Of Mississippi-University Of Mississippi Medical Center is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through State Of Mississippi-University Of Mississippi Medical Center?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to State Of Mississippi-University Of Mississippi Medical Center, in Cardiovascular Disease (Cardiology), Internal Medicine and Neurology. 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. Of these, 4 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does State Of Mississippi-University Of Mississippi Medical Center hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 25D0317204) is associated with this NPI, valid through March 20, 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 State Of Mississippi-University Of Mississippi Medical Center was last updated on March 6, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Ummc Grenada Ekg/eeg Services · NPI 1720419583
General Acute Care Hospital organization in Grenada, Mississippi. Organization record, active in the CMS NPPES registry since December 4, 2013.
## Identity
- **NPI:** 1720419583 (Entity type: Organization)
- **Enumerated:** December 4, 2013
- **Primary specialty:** General Acute Care Hospital · taxonomy 282N00000X
- **Legal business name:** State Of Mississippi-University Of Mississippi Medical Center
- **Organization subpart:** Yes (part of State Of Mississippi-University Of Mississippi Medical Center)
- **Authorized official:** Kevin Cook, CEO
## Practice location
- **Address:** 960 AVENT DR, Grenada, MS 38901-5230
- **Phone:** (662) 227-7000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Internal Medicine (2), Cardiovascular Disease (Cardiology) (1), Neurology (1); 4 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 6, 2014
- **Other identifiers:** Medicare PIN 333900 (MS)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1720419583) · Data from the CMS NPPES public registry.