NPIMap

Organization Active NPI

Appalachian Regional Healthcare, Inc

Doing business as ARH Medical and Specialty Associates - Hazard

  • Rural Health Clinic/Center
  • Hazard, KY
National Provider Identifier
1205400421
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
APPALACHIAN REGIONAL HEALTHCARE, INC
Doing business as
ARH Medical and Specialty Associates - Hazard
Practice address
200 Medical Center Dr
Hazard, KY 41701-9466
Phone
(606) 487-7510
NPI assigned
May 13, 2021
Last updated
Sep 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Authorized official

Name
Mrs. 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

200 Medical Center Dr
Hazard, KY 41701-9466

Mailing address

100 Airport Gardens Rd
Hazard, KY 41701-9529
Phone (606) 216-5145

Other names 1

  • ARH Medical and Specialty Associates - Hazard 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
O20031125000520 KY Part B Supplier - Clinic/Group Practice 0840107835 Receives reassigned benefits from 432 practitioners
48 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20210625002619 KY Part A Provider - Rural Health Clinic 0840107835 Practice locations: Hazard, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205400421. Details of each certification follow.

Rural health clinic certification: CCN 188542

Legal name
APPALACHIAN REGIONAL HEALTHCARE INC
Doing business as
ARH MEDICAL AND SPECIALTY ASSOCIATES - HAZARD
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 23, 2021
Last certification
Sep 23, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jun 28, 1963 in KY
Enrollment address
200 Medical Center Dr
Hazard, KY 41701-9466
Related CCNs
180029

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

Other NPIs on the same Medicare enrollment 35

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

View all 35

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
18D2225696Arh Medical and Specialty Associates - Hazard200 Medical Center Drive, Suite 3F, Hazard, KY 41701Certificate of waiverMay 23, 2027
18D2316574Arh Specialty Associates - Hazard200 Medical Center Drive Suite 1a, Hazard, KY 41701Certificate of waiverJan 7, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 24

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

NameRoleSinceShare
Gregory a Wilson Individual Corporate DirectorBoard Member Nov 8, 2019
Hollie Harris Individual Corporate OfficerPresident and Ceo May 10, 2021
Paul Miles Individual Corporate OfficerVice President and Coo Nov 7, 2008
Gregory Couch Individual Corporate DirectorBoard Member Nov 8, 2013
Maria Benoit Braman Individual Corporate OfficerChief Medical Officer Mar 7, 2016
Crystal Sheaves Individual Corporate DirectorBoard Member Feb 21, 2020
Andrea Massey Individual Corporate DirectorBoard Member Nov 8, 2019
Julie Rose Individual Corporate DirectorBoard Member Nov 5, 2014
Brock Litteral Individual Corporate DirectorBoard Member Nov 2, 2012
Joann Anderson Individual Corporate DirectorBoard Member Nov 2, 2017
Gregory Pauley Individual Corporate DirectorBoard Member Nov 5, 2010
Bessie Ellen Wright Individual Corporate OfficerChief Nursing Officer May 1, 2010
Jeffrey Hollon Individual Corporate DirectorBoard Member Nov 2, 2012
Larry B Francis Individual Corporate DirectorBoard Member Nov 2, 2017
Randall Evans Individual Corporate DirectorBoard Member Nov 8, 2013
Onzie Sizemore Individual Corporate DirectorBoard Member Nov 5, 2014
Theodore T Myre Individual Corporate DirectorBoard Member Nov 2, 2017
James Hart Individual Corporate DirectorBoard Member Nov 2, 2012
Danny Harris Individual Corporate OfficerVice President and Cfo May 1, 2013
Susan Renae Neace Individual W-2 Managing EmployeeSys Dir of Med Aff and Prov Enroll Jan 3, 2005
Michael Rust Individual Corporate DirectorBoard Member Nov 8, 2019
Ken Allman Individual Corporate DirectorBoard Member Nov 8, 2019
Joanna L Santiesteban Individual Corporate DirectorBoard Member Nov 6, 2020
Roy Milwee Individual W-2 Managing EmployeeCeo of Ambulatory Services May 9, 2016

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 24

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

FacilityTypeRoleSince
Harlan Arh HospitalHarlan, KY, CCN 18S050 Hospital 5% Or Greater Direct Ownership Interest
Other		 Jan 1, 1966
Jan 1, 1966
Mary Breckinridge Arh HospitalHyden, KY, CCN 181316 Hospital Operational/Managerial Control (100%) Sep 7, 2011
Barbourville Arh HospitalBarbourville, KY, CCN 18Z328 Hospital 5% Or Greater Direct Ownership Interest (100%) May 31, 2011
Barbourville Arh HospitalBarbourville, KY, CCN 181328 Hospital 5% Or Greater Direct Ownership Interest (100%) May 31, 2011
Arh Our Lady of the WayMartin, KY, CCN 18Z305 Hospital 5% Or Greater Direct Ownership Interest (100%) May 31, 2011
Arh Our Lady of the WayMartin, KY, CCN 181305 Hospital 5% Or Greater Direct Ownership Interest (100%) May 31, 2011
Highlands Arh Regional Medical CenterPrestonsburg, KY, CCN 180005 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 19, 2013
Highlands Arh Regional Medical CenterPrestonsburg, KY, CCN 18S005 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 19, 2013
Paintsville Arh HospitalPaintsville, KY, CCN 180078 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 19, 2013
Arh Advanced Care - Big SandySouth Williamson, KY, CCN 182010 Hospital 5% Or Greater Direct Ownership Interest (100%) May 5, 2021
Arh Advance Care-Ky RiverHazard, KY, CCN 182011 Hospital 5% Or Greater Direct Ownership Interest (100%) May 5, 2021
Mary Breckinridge Arh HospitalHyden, KY, CCN 18Z316 Hospital Operational/Managerial Control Sep 7, 2011
Appalachian Regional Healthcare IncHarlan, KY, CCN 187025 Home health agency 5% Or Greater Indirect Ownership Interest Sep 10, 2008
Mary Breckinridge Arh Home Health AgencyHyden, KY, CCN 187001 Home health agency 5% Or Greater Direct Ownership Interest (100%) May 31, 2011
Highlands Arh Home Health AgencyPrestonsburg, KY, CCN 187169 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jul 19, 2013
Hyden Arh ClinicHyden, KY, CCN 183472 Rural health clinic Operational/Managerial Control (100%) Sep 7, 2011
Arh Cumberland Valley MedicalBarbourville, KY, CCN 183497 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) May 31, 2011
Arh Cumberland Valley Medical and Surgical AssociatesMiddlesboro, KY, CCN 188519 Rural health clinic Operational/Managerial Control (100%) May 31, 2011
Arh Women's and Family Health Center - MiddlesboroMiddlesboro, KY, CCN 188520 Rural health clinic Operational/Managerial Control (100%) Jun 8, 2018
Arh Primary Care Associates - NJMartin, KY, CCN 183442 Rural health clinic Operational/Managerial Control (100%) May 31, 2011
Arh Primary Care Associates - NiMartin, KY, CCN 183440 Rural health clinic Operational/Managerial Control (100%) May 31, 2011
Arh Cumberland Valley Medical and Specialty AssociatesMiddlesboro, KY, CCN 188540 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) May 31, 2011
Arh Medical and Specialty Associates-HighlandsPrestonsburg, KY, CCN 188553 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 19, 2013
Paintsville Arh Medical and Specialty AssociatesPaintsville, KY, CCN 188563 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) May 1, 2023

Practitioners & affiliated clinicians

Practitioners 27

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 27

NPI Registry JSON

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

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726790400000",
    "number": "1205400421",
    "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": "606-216-5145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL CENTER DR",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019466",
            "telephone_number": "606-487-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPALACHIAN REGIONAL HEALTHCARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-13",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "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": "Mrs."
    },
    "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 - Hazard",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ARH Medical and Specialty Associates - Hazard",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hazard, KY

Sources for this page

Verify at the official NPI Registry.