NPIMap

The Hospital Authority of Miller County

Organization Active NPI Rural Health Clinic/Center · Arlington, GA

NPI 1235227752 · NPPES record last updated Nov 2, 2021

Key facts

NPI
1235227752
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
THE HOSPITAL AUTHORITY OF MILLER COUNTY
Practice address
103 Re Jennings Ave SE
Arlington, GA 39813-8725
Phone
(229) 725-4251
Fax
(229) 725-2212
NPI assigned
Oct 10, 2006
Organization subpart
No

Authorized official

Name
Ms. Robin A Rau
Title
Ceo
Phone
(229) 758-5954

Owners & managing parties with NPI records 10

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

Owned or controlled facilities with NPI records 5

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

Other NPIs with the same Medicare PAC ID 10

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

Corporate family (same tax ID) 14

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

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

Facilities with the same owner 5

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

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 31

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Rural health clinic certification: CCN 113497

Legal name
THE HOSPITAL AUTHORITY OF MILLER COUNTY
Doing business as
ROBERT E JENNINGS MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 12, 2001
Last certification
Oct 2, 2019
Ownership / control type
Non-profit – church related
Most recent change of ownership
Feb 1, 2013 (1 total)
Organization structure
Other · Non-profit
Enrollment address
103 R E Jennings Ave SE
Arlington, GA 39813-8725
Related CCNs
111305

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
The Hospital Authority of Miller County
Organization · Colquitt, GA 		5% Or Greater Direct Ownership Interest Feb 4, 2013
Robin a Rau
Individual 		Operational/Managerial Control Sep 8, 2008

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Miller County Hospital
Colquitt, GA · CCN 111305		 Hospital 5% Or Greater Direct Ownership Interest Feb 24, 2014
Miller County Hospital
Colquitt, GA · CCN 11Z305		 Hospital 5% Or Greater Direct Ownership Interest Feb 24, 2014
Miller Nursing Home
Colquitt, GA · CCN 115039		 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 26, 1966
Calhoun Nursing Home
Edison, GA · CCN 115264		 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2013
Miller Home Health
Colquitt, GA · CCN 117801		 Home health agency 5% Or Greater Direct Ownership Interest (100%) Dec 16, 2020

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20130617000633 GA Part a Provider - Rural Health Clinic 0244224947 Practice locations: Arlington, GA

National Provider Directory

Tax ID family
Miller County Hospital (15 organizations share this tax ID)

Interoperability endpoints

  • Direct secure messaging: abbyglass3@hamc.cernerdirect.com

Specialties & licenses

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

Addresses

Primary practice location

103 Re Jennings Ave SE
Arlington, GA 39813-8725

Mailing address

209 N Cuthbert St
Colquitt, GA 39837-3518
Phone (229) 758-4200

Other identifiers

IdentifierTypeStateIssuer
003140349AMedicaidGA

Other names

  • Robert E Jennings Medical Clinic Doing business as

Other providers in Arlington, GA

All providers in Arlington, GA · Rural Health Clinic/Center in Georgia

Sources for this page

Verify at the official NPI Registry.