NPIMap

Organization Active NPI

CCMH Corporation

Doing business as Carroll County Memorial Hospital Swing Bed Unit

  • Critical Access Hospital
  • Carrollton, KY
National Provider Identifier
1003030487
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
600061 Issued in KY
Legal business name
CCMH CORPORATION
Doing business as
Carroll County Memorial Hospital Swing Bed Unit
Practice address
309 11TH St
Carrollton, KY 41008-1435
Phone
(502) 732-3262
NPI assigned
Apr 13, 2007
Last updated
Jun 25, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Sheila Tomlinson
Title
Practice Manager
Phone
(502) 732-3278

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 600061 KY Primary

Addresses

Primary practice location

309 11TH St
Carrollton, KY 41008-1435

Mailing address

309 11TH St
Carrollton, KY 41008-1435
Phone (502) 732-3230

Other names 1

  • Carroll County Memorial Hospital Swing Bed Unit Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080112000080 KY Part A Provider - Critical Access Hospital 2365540465 Practice locations: Carrollton, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003030487. Details of each certification follow.

Hospital certification: CCN 18Z310

Legal name
CCMH CORPORATION
Doing business as
CARROLL COUNTY MEMORIAL HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Oct 16, 1995 in KY
Enrollment address
309 11TH St
Carrollton, KY 41008-1435
Hospital Swing-Bed Unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Robert Yowler Individual Corporate DirectorBoard Member Dec 31, 2013
Jeffrey Scott Nab Individual Corporate DirectorBoard Member Apr 1, 2015
Jim Stephenson Individual Corporate DirectorBoard Secretary Apr 8, 2007
Harold Tomlinson Individual Corporate DirectorBoard Member Apr 8, 2007
Dennis Raisor Individual Corporate DirectorBoard Chairman Jul 1, 2007
Jenniffer Liter Individual Corporate OfficerCeo Mar 14, 2025
W-2 Managing EmployeeCeo Mar 14, 2025
Nick Marsh Individual Corporate DirectorBoard Member Apr 8, 2007

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Carroll County Memorial HospitalCarrollton, KY, CCN 181310 Hospital Operational/Managerial Control (100%) Apr 8, 2007

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • CCMH Corporation

    dba Carroll County Memorial Hospital

    • Critical Access Hospital
    • Carrollton, KY
    • NPI 1225159601

    Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593043200000",
    "number": "1003030487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 11TH ST",
            "city": "CARROLLTON",
            "state": "KY",
            "postal_code": "410081435",
            "telephone_number": "502-732-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 11TH ST",
            "city": "CARROLLTON",
            "state": "KY",
            "postal_code": "410081435",
            "telephone_number": "502-732-3262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCMH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A",
        "authorized_official_last_name": "TOMLINSON",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "502-732-3278",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "KY",
            "license": "600061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carroll County Memorial Hospital Swing Bed Unit",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Carroll County Memorial Hospital Swing Bed Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carrollton, KY

Sources for this page

Verify at the official NPI Registry.