NPIMap

Organization Active NPI

Crenshaw County Health Care Authority

  • Psychiatric Hospital Unit
  • Luverne, AL
National Provider Identifier
1154515591
Registry record updated Jul 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
11790 Issued in AL
Legal business name
CRENSHAW COUNTY HEALTH CARE AUTHORITY
Practice address
101 Hospital Cir
Luverne, AL 36049-7329
Phone
(334) 335-3374
Fax
(334) 335-1217
NPI assigned
Aug 29, 2007
Organization subpart
Yes
Parent organization
CRENSHAW COUNTY HEALTH CARE AUTHORITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 20, 2020

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

Authorized official

Name
Michael Andrew Kimbro
Title
Chairman
Phone
(334) 335-3374

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 11790 AL Primary

Addresses

Primary practice location

101 Hospital Cir
Luverne, AL 36049-7329

Mailing address

101 Hospital Cir
Luverne, AL 36049-7329
Phone (334) 335-3374

Other names 1

  • Crenshaw Community Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250312003679 AL Part A Provider - Hospital 4385073436 Practice locations: Luverne, AL

Hospital certification: CCN 01M308

Legal name
CRENSHAW COUNTY HEALTH CARE AUTHORITY
Doing business as
CRENSHAW COMMUNITY HOSPITAL
Organization structure
LLCNon-profit
Enrollment address
101 Hospital Cir
Luverne, AL 36049-7329
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

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

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Crenshaw Community Hospital2 organizations share this tax ID, including this one
Part of
Crenshaw Community Hospital

Other organizations with this tax ID 1

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

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

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
Rita Brown Individual Corporate DirectorDirector Aug 1, 2023
Yvonne Noble Individual Corporate OfficerDirector Aug 1, 2023
Tonya Jones Individual Corporate DirectorAlabama Jan 1, 2024
Eric Elliott Individual Corporate DirectorDirector Jan 1, 2020
Charles S Tompkins Individual Corporate DirectorChief of Staff Jan 1, 2024
Crenshaw County Health Care Authority Organization, Luverne, AL Non-profit 5% Or Greater Direct Ownership Interest Mar 31, 2020 100%
Operational/Managerial Control Mar 31, 2020
Selena Fowler Individual Corporate DirectorVice Chairman Nov 1, 2023
Martha Williams Individual Corporate DirectorSecretary Treasurer Jan 1, 2021
Blue Management Services LLC Organization, Louisville, KY For-profit Operational/Managerial Control Mar 31, 2020
David Hughes Individual Corporate OfficerCeo May 1, 2018
W-2 Managing Employee May 1, 2018
Michael Kimbro Individual Corporate DirectorChairman Jan 1, 2021
Emmett Speed Individual Corporate DirectorDirector Jan 1, 2021

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Crenshaw Community HospitalLuverne, AL, CCN 011308 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Mar 31, 2020
Mar 31, 2020
Crenshaw Community HospitalLuverne, AL, CCN 01Z308 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Feb 12, 2025
Feb 12, 2025
Crenshaw Family Care CenterLuverne, AL, CCN 013482 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Mar 31, 2020
Mar 31, 2020

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595203200000",
    "number": "1154515591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL CIR",
            "city": "LUVERNE",
            "state": "AL",
            "postal_code": "360497329",
            "telephone_number": "334-335-3374",
            "fax_number": "334-335-1217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL CIR",
            "city": "LUVERNE",
            "state": "AL",
            "postal_code": "360497329",
            "telephone_number": "334-335-3374",
            "fax_number": "334-335-1217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRENSHAW COUNTY HEALTH CARE AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CRENSHAW COUNTY HEALTH CARE AUTHORITY",
        "enumeration_date": "2007-08-29",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A",
        "authorized_official_last_name": "KIMBRO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "334-335-3374"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "AL",
            "license": "11790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crenshaw Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Crenshaw Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Luverne, AL

Sources for this page

Verify at the official NPI Registry.