NPIMap

Organization Active NPI

Madison County Hospital Health Systems, Inc.

Doing business as Madison County Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Madison, FL
National Provider Identifier
1083684856
Registry record updated Jan 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
4346 Issued in FL
Legal business name
MADISON COUNTY HOSPITAL HEALTH SYSTEMS, INC.
Doing business as
Madison County Memorial Hospital
Practice address
224 NW Crane Avenue
Madison, FL 32340-1400
Phone
(850) 973-2271
Fax
(850) 973-2818
NPI assigned
Jan 25, 2006
Last updated
Jan 5, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2015

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

Authorized official

Name
Mr. Patrick McGee
Title
C.F.O.
Phone
(850) 973-2271

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 4346 FL Primary

Addresses

Primary practice location

224 NW Crane Avenue
Madison, FL 32340-1400

Mailing address

224 NW Crane Avenue
Madison, FL 32340-1400
Phone (850) 973-2271

Other identifiers 1

IdentifierTypeStateIssuer
020053100MedicaidFL

Other names 1

  • Madison County Memorial Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220722000305 FL Part A Provider - Critical Access Hospital 2860474111 Practice locations: Madison, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083684856. Details of each certification follow.

Hospital certification: CCN 10Z311

Legal name
MADISON COUNTY HOSPITAL HEALTH SYSTEMS INC
Organization structure
CorporationNon-profit
Enrollment address
224 NW Crane Ave
Madison, FL 32340-1400
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory

Locations

194 NE Hancock Ave
Madison, FL 32340
Phone (850) 253-2275

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Tammy Stevens Individual Corporate OfficerCeo Aug 1, 2014
Carolyn Tuten Individual Corporate Director Jan 1, 2010
W-2 Managing Employee Aug 1, 2014
Karen Annette Johnson Individual Corporate Director Jan 27, 2010
Isham Ben Harris Individual Corporate Director Sep 30, 2008
Shirley Joseph Individual Corporate Director Jan 27, 2010
Patrick McGee Individual Corporate OfficerCfo Aug 1, 2014

Practitioners & affiliated clinicians

Practitioners 27

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 27

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": "1138147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420416000000",
    "number": "1083684856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 NW CRANE AVENUE",
            "city": "MADISON",
            "state": "FL",
            "postal_code": "323401400",
            "telephone_number": "850-973-2271",
            "fax_number": "850-973-2818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 NW CRANE AVENUE",
            "city": "MADISON",
            "state": "FL",
            "postal_code": "323401400",
            "telephone_number": "850-973-2271",
            "fax_number": "850-973-2818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON COUNTY HOSPITAL HEALTH SYSTEMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-25",
        "last_updated": "2015-01-05",
        "status": "A",
        "authorized_official_last_name": "MCGEE",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "C.F.O.",
        "authorized_official_telephone_number": "850-973-2271",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "FL",
            "license": "4346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020053100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madison County Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, FL

Sources for this page

Verify at the official NPI Registry.