NPIMap

Organization Active NPI

Emhfl, Inc

Doing business as Fort Logan Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Stanford, KY
National Provider Identifier
1164578662
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
600066 Issued in KY
Legal business name
EMHFL, INC
Doing business as
Fort Logan Hospital
Practice address
124 Portman Ave
Stanford, KY 40484-1230
Phone
(859) 239-1000
NPI assigned
Jan 26, 2007
Last updated
May 21, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Authorized official

Name
Mike Jackson
Title
President
Phone
(606) 365-4771

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 600066 KY Primary

Addresses

Primary practice location

124 Portman Ave
Stanford, KY 40484-1230

Mailing address

PO Box 1108
Danville, KY 40423-1108
Phone (859) 239-1000

Other identifiers 1

IdentifierTypeStateIssuer
12700563MedicaidKY

Other names 1

  • Fort Logan Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100104000385 KY Part A Provider - Critical Access Hospital 7416842364 Practice locations: Stanford, KY

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1164578662. Details of each certification follow.

Hospital certification: CCN 18Z315

Legal name
EMHFL INC
Doing business as
FORT LOGAN HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Mar 12, 2001 in KY
Enrollment address
110 Metker TRL
Stanford, KY 40484-1020

Hospital certification: CCN 180099

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
FORT LOGAN HOSP
Certification status
Terminated Other: provider status change, Sep 1, 2003
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Apr 27, 2001
Beds
43
Ownership / control type
Other
Facility address
124 Portman Av
Stanford, KY 40484

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

Other NPIs with the same Medicare PAC ID 7

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

  • Emhfl, Inc.

    dba Liberty Family Medical Center

    • Family Medicine Physician
    • Liberty, KY
    • NPI 1023500618

    7416842364

    Same PAC ID
  • Emhfl, Inc.

    dba Fort Logan Profees

    • Certified Registered Nurse Anesthetist
    • Stanford, KY
    • NPI 1114121159

    7416842364

    Same PAC ID
  • Emhfl, Inc.

    dba Fort Logan Walk-in & Primary Care

    • Family Medicine Physician
    • Stanford, KY
    • NPI 1205328895

    7416842364

    Same PAC ID
  • Emhfl, Inc.

    dba Danville Family Physicians

    • Family Medicine Physician
    • Danville, KY
    • NPI 1417436221

    7416842364

    Same PAC ID
  • Emhfl, Inc.

    dba North Garrard Family Medical Center

    • Family Medicine Physician
    • Lancaster, KY
    • NPI 1851883441

    7416842364

    Same PAC ID
  • Emhfl, Inc.

    dba Fort Logan Hospital

    • Critical Access Hospital
    • Stanford, KY
    • NPI 1932254265

    7416842364

    Same PAC ID
  • Emhfl, Inc.

    dba Ephraim McDowell Garrard Clinic

    • Rural Health Clinic/Center
    • Lancaster, KY
    • NPI 1952893620

    7416842364

    Same PAC ID

National Provider Directory

National Provider Directory
Tax ID family
Emhfl Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Dewayne Ruckel Individual Corporate DirectorBoard Member Jan 1, 2022
Daniel McKay Individual Corporate OfficerCeo Jan 1, 2018
W-2 Managing EmployeeCeo Jan 1, 2018
James a Miller Individual Corporate DirectorBoard Member Jan 1, 2022
Lee Smith Individual Corporate DirectorBoard Member Jan 1, 2022
Jerome Flynn Individual Corporate DirectorBoard Member Jan 1, 2018
Donna Wardrip Individual Corporate DirectorBoard Member Jan 1, 2022
Eric Caldwell Individual Corporate DirectorBoard Member Jan 1, 2018
Chris Whitworth Individual Corporate DirectorBoard Member Jan 1, 2022
William Stafford Individual Corporate DirectorBoard Member Jan 1, 2022
Jason Dean Individual Corporate DirectorBoard Member Jan 1, 2022
Ephraim McDowell Health Inc Organization, Danville, KY Non-profit Operational/Managerial Control Jan 25, 1999
Shannon Nicole Long Individual Corporate DirectorBoard Member Jan 1, 2022
Donald Pendygraft Individual Corporate DirectorBoard Member Jan 1, 2022
Sharon McWhorter Individual W-2 Managing EmployeeDirector Jan 1, 2018

Owners & managing parties with NPI records 2

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

Facilities with the same owner 14

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

View all 14

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.

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": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1164578662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1108",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404231108",
            "telephone_number": "859-239-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 PORTMAN AVE",
            "city": "STANFORD",
            "state": "KY",
            "postal_code": "404841230",
            "telephone_number": "859-239-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMHFL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-365-4771"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "KY",
            "license": "600066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12700563",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Logan Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stanford, KY

Sources for this page

Verify at the official NPI Registry.