NPIMap

Organization Active NPI

Perry County Memorial Hospital

  • Rural Health Clinic/Center
  • Tell City, IN
National Provider Identifier
1023009339
Registry record updated May 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
158516 Issued in IN
Legal business name
PERRY COUNTY MEMORIAL HOSPITAL
Practice address
109 US Highway 66 E
Tell City, IN 47586-2755
Phone
(812) 547-3447
Fax
(812) 547-9543
NPI assigned
Nov 4, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2026

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

Authorized official

Name
Crystal Lee Hinton
Title
Provider Enrollment
Phone
(812) 772-0589

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Rural Health Clinic/Center 261QR1300X 158516 IN Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

109 US Highway 66 E
Tell City, IN 47586-2755

Mailing address

8885 State Road 237
Tell City, IN 47586-8567
Phone (812) 547-7011

Other identifiers 5

IdentifierTypeStateIssuer
15D1005855OtherINCLIA
201344410AMedicaidIN
000000242953OtherINANTHEM
65938490MedicaidKY
CK7959OtherINRAILROAD MEDICARE

Other names 1

  • Tell City Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191112000089 IN Part A Provider - Rural Health Clinic 6901871276 Practice locations: Tell City, IN

Rural health clinic certification: CCN 158516

Legal name
PERRY COUNTY MEMORIAL HOSPITAL
Doing business as
TELL CITY CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 18, 2015
Last certification
May 18, 2015
Ownership / control type
Non-profit – church related
Most recent change of ownership
Oct 1, 2019 (1 total)
Organization structure
OtherNon-profit
Enrollment address
109 US Highway 66 E
Tell City, IN 47586-2755
Related CCNs
151322

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

Other NPIs with the same Medicare PAC ID 9

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

National Provider Directory

National Provider Directory
Tax ID family
Perry County Memorial Hospital14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/775a5afe-736f-4ab9-8474-145e99d69207/

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
John B. Land Individual Operational/Managerial ControlBoard Chairman Oct 1, 2019
Randall Russell Individual Contracted Managing EmployeeAd; Jul 1, 2023 100%
Operational/Managerial ControlCfo Jul 1, 2023 100%
Other Jul 1, 2023 100%
Rita Mahoney Individual Operational/Managerial ControlBoard Member Oct 1, 2019
Perry County Memorial Hospital Organization, Tell City, IN 5% Or Greater Direct Ownership Interest Oct 1, 2019 100%
Operational/Managerial Control Oct 1, 2019 100%
Nick Harley Individual Contracted Managing EmployeeCeo Apr 27, 2026 100%
Operational/Managerial ControlCeo Apr 27, 2026 100%

Owners & managing parties with NPI records 9

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Perry County Memorial HospitalTell City, IN, CCN 151322 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Perry County Memorial HospitalTell City, IN, CCN 15Z322 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Perry County Memorial HospitalTell City, IN, CCN 157177 Home health agency Operational/Managerial Control (100%) Jan 5, 2012
Leopold ClinicLeopold, IN, CCN 158517 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2019
Oct 1, 2019

Owned or controlled facilities with NPI records 6

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

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Change-of-ownership history 2

DateEventCounterparty
Oct 1, 2019 Change of OwnershipThis provider was the buyer Tell City ClinicCCN 158516, IN, NPI 1023009339
Oct 1, 2019 Change of OwnershipThis provider was the seller Tell City ClinicCCN 158516, IN, NPI 1023009339

Practitioners & affiliated clinicians

Practitioners 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777939200000",
    "number": "1023009339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8885 STATE ROAD 237",
            "city": "TELL CITY",
            "state": "IN",
            "postal_code": "475868567",
            "telephone_number": "812-547-7011",
            "fax_number": "812-547-0174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 US HIGHWAY 66 E",
            "city": "TELL CITY",
            "state": "IN",
            "postal_code": "475862755",
            "telephone_number": "812-547-3447",
            "fax_number": "812-547-9543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-04",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A",
        "authorized_official_last_name": "HINTON",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "812-772-0589"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "IN",
            "license": "158516",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "15D1005855",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201344410A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000242953",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65938490",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CK7959",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tell City Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tell City, IN

Sources for this page

Verify at the official NPI Registry.