NPIMap

Organization Active NPI

TMC/Higgins General Hospital

Doing business as Tanner Health System

  • Critical Access Hospital
  • Bremen, GA
National Provider Identifier
1194712083
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
TMC/HIGGINS GENERAL HOSPITAL
Doing business as
Tanner Health System
Practice address
200 Allen Memorial Dr
Bremen, GA 30110-2012
Phone
(770) 824-2000
Fax
(770) 824-2309
NPI assigned
Oct 5, 2005
Last updated
Nov 10, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

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

Authorized official

Name
Mr. Lee C. Sherseth
Title
Cfo
Phone
(770) 836-9697

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X GA Primary

Addresses

Primary practice location

200 Allen Memorial Dr
Bremen, GA 30110-2012

Mailing address

200 Allen Memorial Dr
Bremen, GA 30110-2012
Phone (770) 824-2000

Other identifiers 3

IdentifierTypeStateIssuer
000000945AMedicaidGA
300034095DMedicaidGA
300034095EMedicaidGA

Other names 1

  • Tanner Health System Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230202002215 GA Part A Provider - Critical Access Hospital 0547179665 Practice locations: Bremen, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194712083. Details of each certification follow.

Hospital certification: CCN 111320

Legal name
TMC/HIGGINS GENERAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jul 2, 2002
Last certification
May 9, 2024
Beds
25
Ownership / control type
Hospital district or authority
Organization structure
CorporationNon-profit
Incorporated
Jul 1, 1968 in GA
Enrollment address
200 Allen Memorial Dr
Bremen, GA 30110-2012
Main/Primary Hospital Location

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).

Care Compare: Hospital

Medicare Care Compare
Listed as
Higgins General HospitalCCN 111320 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

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 2

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

NameRoleSinceShare
Carol Crews Individual Corporate OfficerCfo Feb 1, 2014
W-2 Managing Employee Feb 1, 2014
Tanner Medical Center Inc Organization, Carrollton, GA Non-profit 5% Or Greater Direct Ownership Interest Jul 8, 2025 100%

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Primary Care of BremenBremen, GA, CCN 118505 Rural health clinic 5% Or Greater Direct Ownership Interest Feb 1, 2003

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 5

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

Practitioners & affiliated clinicians

Practitioners 7

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 151

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

View all 151

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320883200000",
    "number": "1194712083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 ALLEN MEMORIAL DR",
            "city": "BREMEN",
            "state": "GA",
            "postal_code": "301102012",
            "telephone_number": "770-824-2000",
            "fax_number": "770-824-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ALLEN MEMORIAL DR",
            "city": "BREMEN",
            "state": "GA",
            "postal_code": "301102012",
            "telephone_number": "770-824-2000",
            "fax_number": "770-824-2309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TMC/HIGGINS GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-05",
        "last_updated": "2011-11-10",
        "status": "A",
        "authorized_official_last_name": "SHERSETH",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "770-836-9697",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000945A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300034095D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300034095E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tanner Health System",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bremen, GA

Sources for this page

Verify at the official NPI Registry.