Active NPI
Hohenwald Medical Center
- Rural Health Clinic/Center
- Hohenwald, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rural Health Clinic/Center
- Legal business name
- HOHENWALD MEDICAL CENTER
- Practice address
- 20 S Park St
Hohenwald, TN 38462-1413 - Phone
- (931) 796-7960
- Fax
- (931) 796-7790
- NPI assigned
- Feb 10, 2015
- Last updated
- Feb 10, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael E Parker, PA-C
- Title
- Partner
- Phone
- (931) 796-7960
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Primary |
Addresses
Primary practice location
20 S Park St
Hohenwald, TN 38462-1413
Mailing address
20 S Park St
Hohenwald, TN 38462-1413
Phone (931) 796-7960
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 2
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1083005250. Details of each certification follow.
Rural health clinic certification: CCN 448950
- Legal name
- HOHENWALD MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Aug 11, 2015
- Last certification
- May 7, 2024
- Ownership / control type
- 1A
- Organization structure
- Partnership
- Enrollment address
- 20 S Park Street
Hohenwald, TN 38462-1413
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Susan Parker | W-2 Managing Employee | Jul 1, 2004 | |
| Michael Eugene Parker | 5% Or Greater Direct Ownership Interest | Oct 23, 2021 | 100% |
| General Partnership Interest | Oct 23, 2021 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Physician Assistant
- Hohenwald, TN
- NPI 1568426567
5% Or Greater Direct Ownership Interest, General Partnership Interest
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Physician Assistant
- Hohenwald, TN
- NPI 1568426567
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423526400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1423526400000",
"number": "1083005250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 S PARK ST",
"city": "HOHENWALD",
"state": "TN",
"postal_code": "384621413",
"telephone_number": "931-796-7960",
"fax_number": "931-796-7790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 S PARK ST",
"city": "HOHENWALD",
"state": "TN",
"postal_code": "384621413",
"telephone_number": "931-796-7960",
"fax_number": "931-796-7790"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOHENWALD MEDICAL CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2015-02-10",
"last_updated": "2015-02-10",
"status": "A",
"authorized_official_last_name": "PARKER",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "PARTNER",
"authorized_official_telephone_number": "931-796-7960",
"authorized_official_credential": "PA-C"
},
"taxonomies": [
{
"code": "261QR1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rural Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hohenwald, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.