Houston County Healthcare Authority

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

OS12208 Issued in FL

Legal business name

HOUSTON COUNTY HEALTHCARE AUTHORITY

Doing business as

SAMC Specialty Clinic

Practice address

4284 Kelson Ave
Marianna, FL 32446-2948

Phone

(334) 793-8804

Fax

(334) 699-4473

NPI assigned

Jan 9, 2007

Last updated

Mar 8, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

HOUSTON COUNTY HEALTHCARE AUTHORITYAs reported in NPPES

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

Authorized official

Name

Deborah S Woodham, CPC

Title

Contract Manager

Phone

(334) 793-8087

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• SAMC Specialty Clinic Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Part of

Southeast Alabama Med C

Member of 1

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

• Houston County Healthcare Authority

  dba Troy Medical Clinic

  • Internal Medicine Physician
  • Troy, AL
  • NPI 1295065811

  Member Of

  NPD member

Locations

Change-of-ownership history 1

Change of ownership 1

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

• Northwest Florida Healthcare, Inc.

  dba Chipley Medical Group

  • Rural Health Clinic/Center
  • Chipley, FL
  • NPI 1740644202

  Sold to, 2016-03-14

  CMS change of ownership

Practitioners 1

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.

• Deborah B Day, ARNP

  • Nurse Practitioner
  • Chipley, FL
  • NPI 1861445066
  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457395200000",
    "number": "1245389303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1928",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363021928",
            "telephone_number": "334-793-8087",
            "fax_number": "334-793-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4284 KELSON AVE",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324462948",
            "telephone_number": "334-793-8804",
            "fax_number": "334-699-4473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSTON COUNTY HEALTHCARE AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOUSTON COUNTY HEALTHCARE AUTHORITY",
        "enumeration_date": "2007-01-09",
        "last_updated": "2016-03-08",
        "status": "A",
        "authorized_official_last_name": "WOODHAM",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CONTRACT MANAGER",
        "authorized_official_telephone_number": "334-793-8087",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "OS12208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD1649",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "39888B",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "660005100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAMC Specialty Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anastasia Marie Horne, APRN
• Lynette Hornsby, LMHC
• Jordan Horvath
• Housecall Home Health, LLC (Amedisys Home Health)
• Housecall Home Health, LLC (Amedisys Home Health)
• Barron Humphries
• Connie Elizabeth Hurst
• David Bing Hurst, MD
• Judith Ann Hussey, ARNP, BC
• Laura Ingram, LMT

• Neurological Surgery Physician in Marianna, FL
• Providers in Marianna, FL by specialty
• Neurological Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.