Hardin County Regional Health Center
Organization Active NPI Federally Qualified Health Center (FQHC) · Savannah, TN
NPI 1003065772 · NPPES record last updated Jan 27, 2021
Key facts
- NPI
- 1003065772
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- HARDIN COUNTY REGIONAL HEALTH CENTER
- Practice address
- 150 East End Drive
Savannah, TN 38372-1712 - Phone
- (731) 925-2300
- Fax
- (731) 926-1373
- NPI assigned
- Sep 17, 2008
- Organization subpart
- No
Authorized official
- Name
- Yainieh T McGinley
- Title
- Ceo
- Phone
- (731) 925-2300
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 4
Practitioners 30
-
Malory Berry, NP
-
Lauren Rae Droke, RN
-
Donald J Halke, DO
-
Julia M Fields, APRN, PMHNP-BC
-
Christina Sue Free, P.A.
-
Latisha Glaspie-Harris, LPC, MHSP,NCC
-
Leandra Gobbell, FNP
-
Tiffany B Gray, FNP
-
Lindsay Nicole Harbin, M.D.
-
Eric Hart, PHYSICIAN ASSISTANT
-
Katherine Holbrook, LCSW
-
Darin Keith McLain, P.A.
-
Gregory Charles Mitchell, M.D.
-
Angela M Nixon, APN
-
Delca Sue Rickman, LCSW
-
Amie Roland, APN
-
Mandy R Russell, MSN, APRN, NP-C
-
Ashley Shaw, NP
-
William Shaw, NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Federally qualified health center certification: CCN 441907
- Legal name
- HARDIN COUNTY REGIONAL HEALTH CENTER
- Doing business as
- LIFESPAN HEALTH
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Sep 21, 2006
- Last certification
- Sep 21, 2006
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- May 18, 1993 in TN
- Enrollment address
- 150E End Dr
Savannah, TN 38372-1712
All disclosed owners & managing parties 15
| Name | Role | Since | Share |
|---|---|---|---|
| James Baker |
Corporate Director |
Jan 22, 2015 | |
| Vincent Hopson |
Corporate Director | Jul 5, 2006 | |
| Ryan Miller |
Corporate Director |
Dec 13, 2018 | |
| Jennifer Lynn Williams |
Corporate Officer |
Apr 21, 2008 | |
| Matthew McGinley |
Corporate Officer | May 29, 2005 | |
| W-2 Managing Employee | Jul 5, 2006 | ||
| Rita Maxedon |
Corporate Director | Jul 5, 2006 | |
| Stephen Milligan |
Corporate Director | Jul 1, 2008 | |
| June Lafran Plunk |
Corporate Director |
Jul 31, 2022 | |
| Morgan Bo Reynolds |
Corporate Director |
Jul 31, 2022 | |
| Charles Bevis |
Corporate Director | Jul 5, 2006 | |
| Allen Cherry |
Corporate Director | Jul 5, 2006 | |
| Tony Polk |
Corporate Director | Jul 22, 2010 | |
| Cora Damron |
Corporate Director | Jul 5, 2006 | |
| Mina Bhakta |
Corporate Director |
Dec 13, 2018 | |
| Rebecca L Wright |
Corporate Officer |
Oct 22, 2024 | |
| W-2 Managing Employee |
Oct 22, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060801000257 | TN | Part a Provider - Federally Qualified Health Center (FQHC) | 3779490776 |
1 other NPI on this enrollment Practice locations: Savannah, TN |
National Provider Directory
- Tax ID family
- Hardin County Regional Health Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
150 East End Drive
Savannah, TN 38372-1712
Mailing address
PO Box 655
Savannah, TN 38372-0655
Phone (731) 925-2300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0441907 | Medicaid | TN |
Other names
- Lifespan Health
Other providers in Savannah, TN
- Hardin County General Hospital
- Hardin County General Hospital
- Hardin County General Hospital
- Hardin County General Hospital
- Hardin County Regional Health Center
- Hardin County Regional Health Center
- Hardin County Regional Health Center
- Hardin County Regional Health Center
- Hardin County Skills, in.C
- Hardin Emergency Group LLC
All providers in Savannah, TN · Federally Qualified Health Center (FQHC) in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.