NPIMap

Organization Active NPI

Marion Regional Medical Center, Inc.

Doing business as Hamilton Primary Care Center

  • Rural Health Clinic/Center
  • Hamilton, AL
National Provider Identifier
1205254356
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
H4703 Issued in AL
Legal business name
MARION REGIONAL MEDICAL CENTER, INC.
Doing business as
Hamilton Primary Care Center
Practice address
1336 Military St S
Hamilton, AL 35570-5005
Phone
(205) 921-6200
NPI assigned
Apr 4, 2014
Last updated
Mar 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Authorized official

Name
Bruce Toppin
Title
Corporate Secretary
Phone
(662) 377-3978

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X H4703 AL Primary

Addresses

Primary practice location

1336 Military St S
Hamilton, AL 35570-5005

Mailing address

808 Varsity Dr
Tupelo, MS 38801-4613
Phone (662) 377-4685

Other names 1

  • Hamilton Primary Care Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031124000559 AL Part B Supplier - Clinic/Group Practice 1658282322 Receives reassigned benefits from 41 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hamilton, AL
O20160104001978 AL Part A Provider - Rural Health Clinic 1658282322 Practice locations: Hamilton, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205254356. Details of each certification follow.

Rural health clinic certification: CCN 013462

Legal name
MARION REGIONAL MEDICAL CENTER, INC.
Doing business as
HAMILTON PRIMARY CARE CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 10, 2015
Last certification
Jun 10, 2015
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jun 14, 2000 in DE
Enrollment address
1336 Military St S
Hamilton, AL 35570-5005
Related CCNs
010044

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

Other NPIs with the same Medicare PAC ID 3

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

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
01D0665717Hamilton Primary Care Center1336 Military Street South, Hamilton, AL 35570ComplianceAug 17, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Bobby Walace Individual Corporate DirectorBoard Member May 15, 2014
Nancy Diane Karr Individual W-2 Managing Employee May 1, 1993
North Mississippi Health Services Inc Organization, Tupelo, MS Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Oct 1, 2014 100%
5% Or Greater Indirect Ownership Interest Aug 24, 1992 100%
Bruce J Toppin Individual Corporate OfficerSecretary May 15, 2014
Clyde S Nix Individual Corporate DirectorBoard Member May 15, 2014
Sharon D Nobles Individual Corporate OfficerTreasurer Apr 4, 2017
Ken Hammitte Individual Corporate DirectorBoard Member May 15, 2014
Michael S Spees Individual Corporate OfficerCeo and President ( Home Office May 15, 2014
Judy Wilson Individual Corporate DirectorBoard Member May 15, 2014
Alvis E Tidwell Individual Corporate DirectorBoard Member May 15, 2014

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Marion Regional Nursing HomeHamilton, AL, CCN 015167 Skilled nursing facility 5% Or Greater Direct Ownership Interest
Operational/Managerial Control
Adp of the SNF		 Jun 14, 2000
Jun 14, 2000
May 15, 2025
Alabama Homecare of HamiltonHamilton, AL, CCN 017100 Home health agency 5% Or Greater Direct Ownership Interest (33%) Mar 23, 2009

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 33

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

View all 33

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1396569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1205254356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 VARSITY DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014613",
            "telephone_number": "662-377-4685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1336 MILITARY ST S",
            "city": "HAMILTON",
            "state": "AL",
            "postal_code": "355705005",
            "telephone_number": "205-921-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARION REGIONAL MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-04",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "TOPPIN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "CORPORATE SECRETARY",
        "authorized_official_telephone_number": "662-377-3978"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "AL",
            "license": "H4703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hamilton Primary Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hamilton, AL

Sources for this page

Verify at the official NPI Registry.