NPIMap

Organization Active NPI

State of Alabama Dept of Finance

Doing business as Mary Starke Harper Geriatric Psychiatry Center

  • Psychiatric Hospital
  • Tuscaloosa, AL
National Provider Identifier
1033213624
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
STATE OF ALABAMA DEPT OF FINANCE
Doing business as
Mary Starke Harper Geriatric Psychiatry Center
Practice address
115 Harper Court
Tuscaloosa, AL 35401
Phone
(205) 366-3010
Fax
(205) 366-3012
NPI assigned
Sep 12, 2006
Last updated
May 9, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
STATE OF ALABAMA DEPARTMENT OF FINANCEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Authorized official

Name
Melissa D Shaw
Title
Accounting Assistant II
Phone
(205) 366-3038

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X AL Primary

Addresses

Primary practice location

115 Harper Court
Tuscaloosa, AL 35401

Mailing address

PO Box 21231
Tuscaloosa, AL 35402
Phone (205) 366-3010

Other names 1

  • Mary Starke Harper Geriatric Psychiatry Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031205000194 AL Part B Supplier - Clinic/Group Practice 5698684090 Receives reassigned benefits from 32 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tuscaloosa, AL; Mount Vernon, AL; Montgomery, AL; Decatur, AL
O20101025000635 AL Part A Provider - Hospital 5698684090 Practice locations: Tuscaloosa, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033213624. Details of each certification follow.

Hospital certification: CCN 014012

Legal name
STATE OF ALABAMA DEPT OF MENTAL HEALTH & MENTAL RETARDATION
Doing business as
MARY STARKE HARPER GERIATRIC PSYCHIATRY CENTER
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Jul 18, 1996
Last certification
Dec 9, 2009
Beds
96
Ownership / control type
State
Organization structure
OtherNon-profit
Incorporated
Jul 18, 1996 in AL
Enrollment address
115 Harper CT
Tuscaloosa, AL 35401-7454
Other Hospital Practice Location
Hospital subgroups
Psychiatric, Psychiatric unit

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Mary S Harper Geriatric Psychiatry CenterCCN 014012 · All quality measures
Type
Psychiatric
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
01D0999847Mary S Harper Geriatric Psychiatry Ctr115 Harper Court, Tuscaloosa, AL 35401Certificate of waiverMay 23, 2028

National Provider Directory

National Provider Directory
Tax ID family
Alabama Department of Senior Services45 organizations share this tax ID, including this one
Part of
Alabama Department of Senior Services

Other organizations with this tax ID 44

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

View all 44

Locations

1651 Ruby Tyler Pkwy
Tuscaloosa, AL 35404
Phone (205) 507-8000

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Donnell Amerson Individual Corporate OfficerFiscal Manager I Nov 1, 2023
W-2 Managing EmployeeFiscal Manager I Nov 1, 2023
Operational/Managerial ControlFiscal Manager I Nov 1, 2023
Sonja Rawls Individual Corporate DirectorFacility Director Jul 17, 2023
W-2 Managing EmployeeFacility Director Jul 17, 2023
Operational/Managerial ControlFacility Director Jul 17, 2023
State of Alabama Dept of Mental Health & Mental Retardation Organization, Tuscaloosa, AL Non-profit 5% Or Greater Direct Ownership Interest Jul 18, 1996 100%
Operational/Managerial Control Jul 18, 1996 100%

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Bryce HospitalTuscaloosa, AL, CCN 014007 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2012
Jan 1, 2012

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 1

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 26

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 26

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715212800000",
    "number": "1033213624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21231",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "35402",
            "telephone_number": "205-366-3010",
            "fax_number": "205-366-3012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 HARPER COURT",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "35401",
            "telephone_number": "205-366-3010",
            "fax_number": "205-366-3012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF ALABAMA DEPT OF FINANCE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF ALABAMA DEPARTMENT OF  FINANCE",
        "enumeration_date": "2006-09-12",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ACCOUNTING ASSISTANT II",
        "authorized_official_telephone_number": "205-366-3038"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mary Starke Harper Geriatric Psychiatry Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.