NPIMap

Organization Active NPI

Firsthealth of the Carolinas, Inc

Doing business as Montgomery Memorial Hospital (Acute)

  • Critical Access Hospital
  • Troy, NC
National Provider Identifier
1336167675
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
H0003 Issued in NC
Legal business name
FIRSTHEALTH OF THE CAROLINAS, INC
Doing business as
Montgomery Memorial Hospital (Acute)
Practice address
520 Allen St
Troy, NC 27371-2802
Phone
(910) 571-5024
NPI assigned
Jul 17, 2006
Last updated
Dec 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Authorized official

Name
Mickey Foster
Title
Ceo
Phone
(910) 715-4473

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X H0003 NC Primary

Addresses

Primary practice location

520 Allen St
Troy, NC 27371-2802

Mailing address

520 Allen St
Troy, NC 27371-2802
Phone (910) 571-5000

Other names 1

  • Montgomery Memorial Hospital (Acute) Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061104000414 NC Part A Provider - Critical Access Hospital 8820909377 Practice locations: Troy, NC
O20090102000039 NC Part A Provider - Rural Health Clinic 8820909377 Practice locations: Troy, NC

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1336167675. Details of each certification follow.

Hospital certification: CCN 341303

Legal name
FIRSTHEALTH OF THE CAROLINAS INC
Doing business as
FIRSTHEALTH MONTGOMERY MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Apr 1, 1999
Last certification
Aug 4, 2004
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Aug 21, 1995 in NC
Enrollment address
520 Allen St
Troy, NC 27371-2802

Rural health clinic certification: CCN 343431

Legal name
FIRSTHEALTH OF THE CAROLINAS INC
Doing business as
FIRSTHEALTH MONTGOMERY MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 17, 2009
Last certification
Feb 18, 2016
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Aug 21, 1995 in NC
Enrollment address
522 Allen St
Troy, NC 27371-2861
Related CCNs
341303

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

Other NPIs with the same Medicare PAC ID 11

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Firsthealth Montgomery Memorial HospCCN 341303 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Firsthealth of the Carolinas Inc Dba Firsthealth Neurology27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

Ownership & related parties

All disclosed owners & managing parties 26

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

NameRoleSinceShare
Judy W Lemonds Individual Corporate Director Dec 7, 2004
W-2 Managing Employee Aug 26, 1996
Susan R Purser Individual Corporate DirectorBoard Member Sep 18, 2012
Operational/Managerial ControlBoard Member Sep 18, 2012
Corporate Director Sep 1, 2008
Frank Michael Lachina Individual Corporate Director Jan 6, 2005
W-2 Managing Employee Jan 2, 2001
Thomas Swantkowski Individual Corporate Director Jan 6, 2005
Carolyn D Helms Individual Corporate DirectorBoard Member Sep 18, 2012
Operational/Managerial ControlBoard Member Sep 18, 2012
Walter S Fasolak Individual Corporate DirectorBoard Member Dec 7, 2004
Operational/Managerial ControlBoard Member Sep 18, 2012
Corporate Director Sep 1, 2008
James H Bulthuis Individual Corporate DirectorBoard Member Sep 18, 2012
Operational/Managerial ControlBoard Member Sep 18, 2012
Operational/Managerial Control Sep 18, 2012
James Tart Individual Corporate Director Jan 6, 2005
Mickey Foster Individual Corporate Director Aug 1, 2020
W-2 Managing Employee Aug 1, 2020
Corporate Officer Aug 1, 2020
David M Cowherd Individual Corporate DirectorBoard Member Sep 18, 2012
Operational/Managerial ControlBoard Member Sep 18, 2012
Operational/Managerial ControlBord Member Sep 18, 2012
John S Stevenson Individual Corporate DirectorBoard Member Jan 6, 2005
Operational/Managerial ControlBoard Member Sep 18, 2012
Corporate Director Sep 1, 2008
John M May Individual Corporate DirectorBoard Member Dec 7, 2004
Operational/Managerial ControlBoard Member Sep 18, 2012
Corporate Director Sep 1, 2008
Stephen a Szabo Individual Corporate DirectorBoard Member Sep 18, 2012
Operational/Managerial ControlBoard Member Sep 18, 2012
Don R Bahner Individual Corporate DirectorBoard Member Sep 18, 2012
Operational/Managerial ControlBoard Member Sep 18, 2012
Corporate Director Sep 1, 2008
Robert Alexander Bowness Individual Corporate DirectorBoard Member Sep 18, 2012
Operational/Managerial ControlBoard Member Sep 18, 2012
Corporate Director Sep 1, 2008
William L Stewart Individual Corporate DirectorBoard Member Sep 18, 2012
Operational/Managerial ControlBoard Member Sep 18, 2012
Corporate Director Sep 1, 2008
David L Burns Individual Corporate DirectorBoard Member Sep 18, 2012
Operational/Managerial ControlBoard Member Sep 18, 2012
Corporate Director Sep 1, 2008
Thomas Phillips Individual Corporate Director Jan 6, 2005
Kerry Hensley Individual Corporate Director Jan 6, 2005
W-2 Managing Employee Oct 1, 2004
Firsthealth of the Carolinas Inc Organization, Pinehurst, NC Chain home office 5% Or Greater Direct Ownership Interest Aug 21, 1995 100%
Operational/Managerial Control Jun 23, 2010
Bruce S Solomon Individual Corporate DirectorBoard Member Sep 18, 2012
Operational/Managerial ControlBoard Member Sep 18, 2012
Corporate Director Sep 1, 2008
Anna G Hollers Individual Corporate DirectorBoard Member Sep 18, 2012
Operational/Managerial ControlBoard Member Sep 18, 2012
Corporate Director Sep 1, 2008
Roberta Quis Individual Corporate Director Jan 6, 2005
Julian W King Individual Corporate DirectorBoard Member Sep 18, 2012
Operational/Managerial ControlBoard Member Sep 18, 2012
Corporate Director Sep 1, 2008
David B Woronoff Individual Corporate DirectorBoard Member Sep 18, 2012
Operational/Managerial ControlBoard Member Sep 18, 2012
Corporate Director Sep 1, 2008
John N Ellis Individual Corporate DirectorBoard Member Sep 18, 2012
Operational/Managerial ControlBoard Member Sep 18, 2012

Owners & managing parties with NPI records 17

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

View all 17

All facility ownership & control disclosures 7

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

FacilityTypeRoleSince
Firsthealth Moore Regional HospitalPinehurst, NC, CCN 340115 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 19, 2007
Moore Regional Hospital Professional ServicesPinehurst, NC, CCN 34S115 Hospital 5% Or Greater Indirect Ownership Interest Aug 21, 1995
Firsthealth Moore Regional Hospital RehabPinehurst, NC, CCN 34T115 Hospital 5% Or Greater Direct Ownership Interest (100%) Aug 21, 1995
Firsthealth Montgomery Memorial HospitalTroy, NC, CCN 34Z303 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Aug 21, 1995
First Health Home CareWest End, NC, CCN 347230 Home health agency 5% Or Greater Direct Ownership Interest (100%) Oct 8, 2010
First Health Home Care - RichmondRockingham, NC, CCN 347041 Home health agency 5% Or Greater Direct Ownership Interest Aug 10, 2010
Firsthealth Hospice and Palliative CareWest End, NC, CCN 341534 Hospice Operational/Managerial Control Oct 9, 2002

Owned or controlled facilities with NPI records 10

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

Facilities with the same owner 7

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

Practitioners & affiliated clinicians

Affiliated clinicians 71

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 71

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1336167675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 ALLEN ST",
            "city": "TROY",
            "state": "NC",
            "postal_code": "273712802",
            "telephone_number": "910-571-5000",
            "fax_number": "910-715-1926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 ALLEN ST",
            "city": "TROY",
            "state": "NC",
            "postal_code": "273712802",
            "telephone_number": "910-571-5024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRSTHEALTH OF THE CAROLINAS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-715-4473"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NC",
            "license": "H0003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montgomery Memorial Hospital (Acute)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Montgomery Memorial Hospital (Acute)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Troy, NC

Sources for this page

Verify at the official NPI Registry.