NPIMap

Organization Active NPI

Russell County Community Hospital LLC

Doing business as Jack Hughston Memorial Hospital

  • General Acute Care Hospital
  • Phenix City, AL
National Provider Identifier
1023050101
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
H5703 Issued in AL
Legal business name
RUSSELL COUNTY COMMUNITY HOSPITAL LLC
Doing business as
Jack Hughston Memorial Hospital
Practice address
4401 River Chase Dr
Phenix City, AL 36867-7483
Phone
(334) 732-3000
Fax
(334) 732-3020
NPI assigned
Jun 12, 2006
Last updated
Apr 4, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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

Authorized official

Name
Mrs. Rachael H. Crenshaw
Title
Chief Operating Officer
Phone
(334) 732-3010

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X H5703 AL Primary
General Acute Care Hospital 282N00000X

Addresses

Primary practice location

4401 River Chase Dr
Phenix City, AL 36867-7483

Mailing address

4401 River Chase Drive
Phenix City, AL 36867-7483
Phone (334) 732-3000

Other names 1

  • Jack Hughston Memorial Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060714000105 AL Part A Provider - Hospital 6305859372 Practice locations: Phenix City, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023050101. Details of each certification follow.

Hospital certification: CCN 010168

Legal name
RUSSELL COUNTY COMMUNITY HOSPITAL, LLC
Doing business as
JACK HUGHSTON MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Sep 1, 2006
Last certification
Sep 2, 2006
Beds
70
Ownership / control type
State
Organization structure
LLCProprietary
Incorporated
Apr 8, 2003 in AL
Enrollment address
4401 River Chase Dr
Phenix City, AL 36867-7483
Other Hospital Practice Location
Hospital subgroups
General

Care Compare: Hospital

Medicare Care Compare
Listed as
Jack Hughston Memorial HospitalCCN 010168 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Government - State
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D1054322Jack Hughston Memorial Hospital Lab4401 River Chase Drive, Phenix City, AL 36867AccreditationNov 5, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 26

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

NameRoleSinceShare
Champ L Baker Individual 5% Or Greater Direct Ownership InterestOwner Jan 1, 2025 5.25%
L Erik Westerlund Individual 5% Or Greater Direct Ownership InterestOwner Jan 1, 2025 5.25%
James McGrory Individual 5% Or Greater Direct Ownership InterestOwner Jan 1, 2025 5.25%
Lyle a Norwood Individual OtherOwner Jan 1, 2025 2%
Garland Kieth Gudger Individual 5% Or Greater Direct Ownership InterestOwner Jan 1, 2025 5.25%
Benjamin Watson Individual 5% Or Greater Direct Ownership InterestOwner Jan 1, 2025 5.25%
Carlton G Savory Individual OtherOwner Jan 1, 2025 2%
David C Rehak Individual 5% Or Greater Direct Ownership InterestOwner Jan 1, 2025 5.25%
Ryan M Geringer Individual 5% Or Greater Direct Ownership InterestOwner Jan 1, 2025 5.25%
Patrick J Fernicola Individual 5% Or Greater Direct Ownership InterestOwner Jan 1, 2025 5.25%
David H Macdonald Individual 5% Or Greater Direct Ownership InterestOwner Jan 1, 2025 5.25%
John K Burkus Individual OtherOwner Jan 1, 2025 2%
Mark Baker Individual Corporate OfficerCeo Feb 5, 2009
Corporate Director Feb 5, 2009
Randall Joseph Ruark Individual 5% Or Greater Direct Ownership InterestOwner Jan 1, 2025 5.25%
Curtis Keith Harnage Individual W-2 Managing EmployeeCfo Dec 31, 2022
Douglas W Pahl Individual 5% Or Greater Direct Ownership InterestOwner Jan 1, 2025 5.25%
David Michael Gloystein Individual 5% Or Greater Direct Ownership InterestOwner Jan 1, 2025 5.25%
Kurt E Jacobson Individual OtherOwner Jan 1, 2025 4%
Thomas N Bernard Individual OtherOwner Jan 1, 2025 2%
Matthew Garrett Stewart Individual 5% Or Greater Direct Ownership InterestOwner Jan 1, 2025 5.25%
Rachael Crenshaw Individual Corporate OfficerChief Compliance Officer Dec 31, 2022
Operational/Managerial ControlChief Compliance Officer Dec 31, 2022
Norman L Donati Individual OtherOwner Jan 1, 2025 2%
John D Dorchak Individual 5% Or Greater Direct Ownership InterestOwner Jan 1, 2025 5.25%
Michael M Tucker Individual 5% Or Greater Direct Ownership InterestOwner Jan 1, 2025 5.25%
Garland K Gudger Individual OtherOwner Jan 1, 2025 2%
Frederick C. Flandry Individual 5% Or Greater Direct Ownership InterestOwner Jan 1, 2025 5.25%

Owners & managing parties with NPI records 20

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

View all 20

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

Affiliated clinicians 100

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

View all 100

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333497600000",
    "number": "1023050101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 RIVER CHASE DRIVE",
            "city": "PHENIX CITY",
            "state": "AL",
            "postal_code": "368677483",
            "telephone_number": "334-732-3000",
            "fax_number": "334-732-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 RIVER CHASE DR",
            "city": "PHENIX CITY",
            "state": "AL",
            "postal_code": "368677483",
            "telephone_number": "334-732-3000",
            "fax_number": "334-732-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL COUNTY COMMUNITY HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2012-04-04",
        "status": "A",
        "authorized_official_last_name": "CRENSHAW",
        "authorized_official_first_name": "RACHAEL",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "334-732-3010",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "AL",
            "license": "H5703",
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jack Hughston Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phenix City, AL

Sources for this page

Verify at the official NPI Registry.