NPIMap

Organization Active NPI

CCMH Corporation

  • 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
Practice address
309 11TH St
Carrollton, KY 41008-1435
Phone
(502) 732-3262
NPI assigned
Apr 13, 2007
Organization subpart
No

Authorized official

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

Owned or controlled facilities with NPI records 1

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

Other NPIs with the same Medicare PAC ID 5

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

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

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

Medicare participation

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

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.

Enrollment records 1

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

All disclosed owners & managing parties 7

Medicare enrollment files

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

Medicare enrollment files

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

National Provider Directory

National Provider Directory

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

Primary practice location

309 11TH St
Carrollton, KY 41008-1435

Mailing address

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

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
000000515901OtherKYBLUE CROSS
2864664000OtherKYPASSPORT ADVANTAGE

Other names 1

NPPES NPI Registry
  • Carroll County Memorial Hospital Swing Bed Unit Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 25, 2020.

{
    "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000000515901",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT  ADVANTAGE",
            "identifier": "2864664000",
            "state": "KY"
        }
    ],
    "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.