NPIMap

Organization Active NPI

Perry County Memorial Hospital

Doing business as Leopold Clinic

  • Rural Health Clinic/Center
  • Leopold, IN
National Provider Identifier
1215928536
Registry record updated May 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
PERRY COUNTY MEMORIAL HOSPITAL
Doing business as
Leopold Clinic
Perry County Family Practice
Practice address
18485 State Road 37
Leopold, IN 47551-8072
Phone
(812) 843-3038
Fax
(812) 772-0594
NPI assigned
Nov 4, 2005
Last updated
May 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2026

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

Authorized official

Name
Crystal Lee Hinton
Title
Provider Enrollment
Phone
(812) 772-0589

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

18485 State Road 37
Leopold, IN 47551-8072

Mailing address

8885 State Road 237
Tell City, IN 47586-8567
Phone (812) 547-7011

Other identifiers 7

IdentifierTypeStateIssuer
200531240AMedicaidIN
300101201MedicaidIN
78904927MedicaidKY
15D1043196OtherINCLIA
300032719MedicaidIN
65944290MedicaidKY
000000371434OtherINANTHEM

Other names 2

  • Leopold Clinic Doing business as
  • Perry County Family Practice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050825000962 IN Part B Supplier - Clinic/Group Practice 6204867559 Receives reassigned benefits from 6 practitioners
Practice locations: Leopold, IN
O20200619000580 IN Part A Provider - Rural Health Clinic 6901871276 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Leopold, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215928536. Details of each certification follow.

Rural health clinic certification: CCN 158517

Legal name
PERRY COUNTY MEMORIAL HOSPITAL
Doing business as
LEOPOLD CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 19, 2015
Last certification
May 19, 2015
Ownership / control type
Non-profit – church related
Most recent change of ownership
Oct 1, 2019 (1 total)
Organization structure
OtherNon-profit
Enrollment address
18485 State Road 37
Leopold, IN 47551-8072
Related CCNs
151322

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Perry County Memorial H14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

18485 State Road 37
Leopold, IN 47551
Phone (812) 547-3447

715 Main St
Tell City, IN 47586
Phone (812) 482-6424

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
John B. Land Individual Operational/Managerial ControlBoard of Directors Chairman Oct 1, 2019
Randall Russell Individual Contracted Managing EmployeeCfo Jul 1, 2023
Operational/Managerial ControlCfo Jul 1, 2023
Rita Mahoney Individual Operational/Managerial ControlBoard of Directors Oct 1, 2019
Perry County Memorial Hospital Organization, Leopold, IN 5% Or Greater Direct Ownership Interest Oct 1, 2019 100%
Operational/Managerial Control Oct 1, 2019 100%
Jared Stimpson Individual Operational/Managerial ControlBoard Member Jul 1, 2023
Nick Harley Individual Contracted Managing EmployeeCeo Mar 23, 2026
Corporate OfficerCeo Mar 23, 2026
Operational/Managerial ControlCeo Mar 23, 2026

Owners & managing parties with NPI records 10

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

Change-of-ownership history 1

DateEventCounterparty
Oct 1, 2019 Change of OwnershipThis provider was the seller Leopold ClinicCCN 158517, IN, NPI 1629621396

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777939200000",
    "number": "1215928536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8885 STATE ROAD 237",
            "city": "TELL CITY",
            "state": "IN",
            "postal_code": "475868567",
            "telephone_number": "812-547-7011",
            "fax_number": "812-772-0594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18485 STATE ROAD 37",
            "city": "LEOPOLD",
            "state": "IN",
            "postal_code": "475518072",
            "telephone_number": "812-843-3038",
            "fax_number": "812-772-0594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-04",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A",
        "authorized_official_last_name": "HINTON",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "812-772-0589"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200531240A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300101201",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78904927",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "15D1043196",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300032719",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65944290",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000371434",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Leopold Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Perry County Family Practice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Perry County Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leopold, IN

Sources for this page

Verify at the official NPI Registry.