NPIMap

Organization Active NPI

Cullman Regional Medical Center, Inc

  • General Acute Care Hospital
  • Cullman, AL
National Provider Identifier
1114919339
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
H2201 Issued in AL
Legal business name
CULLMAN REGIONAL MEDICAL CENTER, INC
Practice address
1912 Al Highway 157
Cullman, AL 35058-0609
Phone
(256) 737-2000
Fax
(256) 737-2005
NPI assigned
Aug 16, 2005
Last updated
Jun 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Authorized official

Name
Nesha Donaldson
Title
Cfo
Phone
(256) 737-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X H2201 AL Primary

Addresses

Primary practice location

1912 Al Highway 157
Cullman, AL 35058-0609

Mailing address

PO Box 1108
Cullman, AL 35056-1108
Phone (256) 737-2000

Other identifiers 3

IdentifierTypeStateIssuer
010049OtherALBLUE CROSS
51507378OtherALLAB PROVIDER #
HOS0035HMedicaidAL

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040130000280 AL Part B Supplier - Clinic/Group Practice 3274445242 Receives reassigned benefits from 31 practitioners
1 other NPI on this enrollment
Practice locations: Cullman, AL
O20070703000520 AL Part A Provider - Hospital 3274445242 Practice locations: Hartselle, AL; Cullman, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114919339. Details of each certification follow.

Hospital certification: CCN 010035

Legal name
CULLMAN REGIONAL MEDICAL CENTER INC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 16, 2001
Beds
115
Ownership / control type
Hospital district or authority
Organization structure
CorporationNon-profit
Incorporated
Aug 25, 1969 in AL
Enrollment address
1912 Al Highway 157
Cullman, AL 35058-0609
Main/Primary Hospital Location
Hospital subgroups
General

Other NPIs with the same Medicare PAC ID 5

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.

Care Compare: Hospital

Medicare Care Compare
Listed as
Cullman Regional Medical CenterCCN 010035 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Cullman Reg Medblount SP12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Sara T Baker Individual Corporate DirectorSecretary Apr 30, 2024
Dennis W Richard Individual Corporate DirectorTreasurer Apr 30, 2024
James Clements Individual Corporate OfficerChief Executive Officer May 11, 2015
W-2 Managing EmployeeCeo May 11, 2015
Nesha Donaldson Individual W-2 Managing EmployeeCfo Mar 4, 2012
Timothy P Culpepper Individual Corporate DirectorChairman Apr 20, 2024
Health Care Authority of Cullman Organization, Cullman, AL Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 1995 100%
Perry D Knight Individual Corporate DirectorVice Chairman Apr 30, 2024

Owners & managing parties with NPI records 1

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

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 63

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 63

Affiliated clinicians 393

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

View all 393

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687392000000",
    "number": "1114919339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1108",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350561108",
            "telephone_number": "256-737-2000",
            "fax_number": "256-737-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 AL HIGHWAY 157",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350580609",
            "telephone_number": "256-737-2000",
            "fax_number": "256-737-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CULLMAN REGIONAL MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-16",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A",
        "authorized_official_last_name": "DONALDSON",
        "authorized_official_first_name": "NESHA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "256-737-2000"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "AL",
            "license": "H2201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "010049",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LAB PROVIDER #",
            "identifier": "51507378",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HOS0035H",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cullman, AL

Sources for this page

Verify at the official NPI Registry.