NPIMap

Organization Active NPI

Calhoun-Liberty Hospital Association Inc

  • Skilled Nursing Facility
  • Blountstown, FL
National Provider Identifier
1033434196
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
4019 Issued in FL
Legal business name
CALHOUN-LIBERTY HOSPITAL ASSOCIATION INC
Practice address
16257 State Road 71 S
Blountstown, FL 32424-2808
Phone
(850) 674-5411
Fax
(800) 287-4394
NPI assigned
Apr 1, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Authorized official

Name
Emily Marlo Brown
Title
Chief Executive Officer
Phone
(850) 674-5411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 4019 FL Primary

Addresses

Primary practice location

16257 State Road 71 S
Blountstown, FL 32424-2808

Mailing address

16257 State Road 71 S
Blountstown, FL 32424-2808
Phone (850) 674-5411

Other identifiers 1

IdentifierTypeStateIssuer
020389100MedicaidFL

Other names 1

  • CALHOUN-LIBERTY HOSPITAL Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220722000657 FL Part A Provider - Critical Access Hospital 8820007016 Receives reassigned benefits from 9 practitioners
Practice locations: Blountstown, FL

Hospital certification: CCN 10Z304

Legal name
CALHOUN-LIBERTY HOSPITAL ASSOCIATION INC
Doing business as
CALHOUN LIBERTY HOSPITAL
Organization structure
CorporationNon-profit
Enrollment address
16257 State Road 71 S
Blountstown, FL 32424-2808

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

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory

Locations

20382 NW Pennington Ave
Blountstown, FL 32424
Phone (850) 674-5411

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/liberty-4ff80e3e

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Mary Sue Neves Individual Corporate Director Jan 1, 2018
Melba Anne Faurot Individual Corporate Director Oct 1, 2017
Laban Bontrager Individual Corporate Director Jan 1, 2006
Marilyn Russell Individual Corporate Director Jan 1, 2006
Laddie Williams Individual Corporate Director Jan 1, 2006
John Tomlinson Individual Corporate Director Jan 1, 2006
Emily Brown Individual Operational/Managerial ControlCeo Feb 4, 2025 100%
Harrel Tim Revell Individual Corporate Director Jan 1, 2017
Vann Windham Individual W-2 Managing Employee Jan 1, 2023
Terry Eubanks Individual Corporate Director Jan 1, 2018
Calhoun-Liberty Hospital Association Inc Organization, Blountstown, FL Non-profit Operational/Managerial Control Dec 20, 2005 100%
Mark Plummer Individual Corporate DirectorChairman of the Board Jan 1, 2018

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 22

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

View all 22

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1270080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764806400000",
    "number": "1033434196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16257 STATE ROAD 71 S",
            "city": "BLOUNTSTOWN",
            "state": "FL",
            "postal_code": "324242808",
            "telephone_number": "850-674-5411",
            "fax_number": "800-287-4394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16257 STATE ROAD 71 S",
            "city": "BLOUNTSTOWN",
            "state": "FL",
            "postal_code": "324242808",
            "telephone_number": "850-674-5411",
            "fax_number": "800-287-4394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALHOUN-LIBERTY HOSPITAL ASSOCIATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-01",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "MARLO",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "850-674-5411"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "4019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020389100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CALHOUN-LIBERTY HOSPITAL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Blountstown, FL

Sources for this page

Verify at the official NPI Registry.