NPIMap

Organization Active NPI

Arh Mary Breckinridge Health Services, Inc.

Doing business as ARH Medical and Specialty Associates - Harold

  • Rural Health Clinic/Center
  • Harold, KY
National Provider Identifier
1194351460
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ARH MARY BRECKINRIDGE HEALTH SERVICES, INC.
Doing business as
ARH Medical and Specialty Associates - Harold
Practice address
24 Left Penhook Rd
Harold, KY 41635-7064
Phone
(606) 478-8787
NPI assigned
Mar 19, 2020
Last updated
Sep 18, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
APPALACHIAN REGIONAL HELATHCARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Authorized official

Name
Ms. Hollie Harris
Title
President and Ceo
Phone
(859) 226-2511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

24 Left Penhook Rd
Harold, KY 41635-7064

Mailing address

100 Airport Gardens Rd
Hazard, KY 41701-9529
Phone (606) 487-7524

Other names 1

  • ARH Medical and Specialty Associates - Harold Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170728001694 KY Part B Supplier - Clinic/Group Practice 8123293818 Receives reassigned benefits from 97 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pikeville, KY; Martin, KY; Crestwood, KY; Louisville, KY; Lexington, KY; Harold, KY; Barbourville, KY; Ashland, KY
O20200505000268 KY Part A Provider - Rural Health Clinic 8123293818 Practice locations: Harold, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194351460. Details of each certification follow.

Rural health clinic certification: CCN 183477

Legal name
ARH MARY BRECKINRIDGE HEALTH SERVICES INC
Doing business as
ARH MEDICAL AND SPECIALTY ASSOCIATES - HAROLD
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 1, 2012
Last certification
Feb 26, 2020
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
May 31, 2011 in KY
Enrollment address
24 Left Penhook Rd
Harold, KY 41635-7064
Related CCNs
181305

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

Other NPIs with the same Medicare PAC ID 17

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

View all 17

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D0937843Arh Medical and Specialty Associates Harold24 Left Penhook Road, Harold, KY 41635Certificate of waiverJul 23, 2027

National Provider Directory

National Provider Directory
Part of
Appalachian Regional Inc

Locations

2032 Cumberland Ave
Middlesboro, KY 40965
Phone (606) 245-4833

3504 Cumberland Ave
Middlesboro, KY 40965
Phone (606) 248-0737

302 S Walnut St
Pineville, KY 40977
Phone (606) 302-2034

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
Hollie Harris Individual OtherPresident & Ceo May 10, 2021
Andrea Massey Individual Corporate DirectorBoard Member Nov 8, 2019
Christi Lee Individual Corporate OfficerSecretary Nov 28, 2023
Byron Lynn Gabbard Individual Corporate OfficerTreasurer Nov 28, 2023
Vanessa Johnson Individual W-2 Managing Employee Aug 1, 2017
Roy Milwee Individual W-2 Managing EmployeeSystem Admin of Ambulatory Services May 9, 2016

Change-of-ownership history 1

DateEventCounterparty
Apr 30, 2020 Change of OwnershipThis provider was the buyer Arh Medical and Specialty Associates - HaroldCCN 183477, KY, NPI 1033778782

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1194351460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 AIRPORT GARDENS RD",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019529",
            "telephone_number": "606-487-7524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 LEFT PENHOOK RD",
            "city": "HAROLD",
            "state": "KY",
            "postal_code": "416357064",
            "telephone_number": "606-478-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARH MARY BRECKINRIDGE HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "APPALACHIAN REGIONAL HELATHCARE, INC.",
        "enumeration_date": "2020-03-19",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "HOLLIE",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "859-226-2511",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ARH Medical and Specialty Associates - Harold",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ARH Medical and Specialty Associates - Harold",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harold, KY

Sources for this page

Verify at the official NPI Registry.