NPIMap

Holmes County Hospital Corp

Organization Active NPI Critical Access Hospital · Bonifay, FL

NPI 1366431702 · NPPES record last updated Mar 31, 2022

Key facts

NPI
1366431702
Entity type
Organization (NPI type 2)
Primary specialty
Critical Access Hospital 282NC0060X
License
4427 (FL)
Legal business name
HOLMES COUNTY HOSPITAL CORP
Practice address
2600 Hospital Drive
Bonifay, FL 32425
Phone
(850) 547-8015
Fax
(850) 547-8025
NPI assigned
Oct 18, 2005
Organization subpart
No

Authorized official

Name
Mrs. Joann Baker
Title
Administrator/Ceo
Phone
(850) 547-8001

Owned or controlled facilities with NPI records 1

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

Other NPIs on the same Medicare enrollment 2

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

Other NPIs with the same Medicare PAC ID 1

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

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

Practitioners 59

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

View all 59

Affiliated clinicians 87

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

View all 87

Medicare Care Compare: Hospital

Listed as
Doctors Memorial Hospital CCN 101307
Overall star rating
★★☆☆☆ 2 of 5
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
Active (Provider of Services file)
Emergency services
No

Source: Medicare Care Compare.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0270672Doctors Memorial Hospital
2600 Hospital Dr, Bonifay, FL 32425		AccreditationJan 2, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled (3 enrollments) in FL

Hospital certification: CCN 101307

Legal name
HOLMES COUNTY HOSPITAL CORP
Doing business as
DOCTORS MEMORIAL HOSPITAL - BONIFAY
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jul 1, 2002
Last certification
Jun 13, 2002
Beds
20
Ownership / control type
Hospital district or authority
Organization structure
Corporation · Non-profit
Incorporated
Apr 23, 1955 in FL
Enrollment address
2600 Hospital Dr
Bonifay, FL 32425-4264
Other Hospital Practice Location
Hospital subgroups
General, Acute care

Hospital certification: CCN 10Z307

Legal name
HOLMES COUNTY HOSPITAL CORP
Doing business as
DOCTORS MEMORIAL HOSPITAL
Organization structure
Corporation · Non-profit
Incorporated
in FL
Enrollment address
2600 Hospital Drive
Doctors Memorial Hospital
Bonifay, FL 32425-0188
Other Hospital Practice Location

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Heather Nelson
Individual 		Other Jul 1, 2021
Ronald C Jamison
Individual 		Corporate Officer
Chief Financial Officer		 Sep 16, 2020
Donna Boroughs
Individual 		Other
Business Office Director		 Apr 1, 2008
W-2 Managing Employee
Business Office Manager		 Jul 1, 2002
Cynthia Brooks
Individual 		Corporate Director
Chairman of the Board		 Dec 20, 2019 5%
Rohan Anderson
Individual 		Operational/Managerial Control
Ceo		 Jan 28, 2025
Jennie Goodman
Individual 		Other
Board Member		 Aug 27, 2020
Joann Baker
Individual 		5% Or Greater Indirect Ownership Interest Feb 1, 2010
W-2 Managing Employee
Administrator/Ceo		 Feb 1, 2010 100%
Corporate Officer
Ceo/Administrator		 Jul 1, 2002 100%
W-2 Managing Employee
Ceo/Administrator		 Jul 1, 2002 100%
Operational/Managerial Control
Ceo/Administrator		 Jul 1, 2002 100%
Jerry Dixon
Individual 		Other
Board Member		 Aug 27, 2020

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Bonifay Rural Health Clinic
Bonifay, FL · CCN 103462		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Dec 31, 2020

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20060203000151 FL Part a Provider - Hospital 3375557887 Practice locations: Bonifay, FL
O20101122001377 FL Part B Supplier - Clinic/Group Practice 3375557887 Receives reassigned benefits from 56 practitioners
2 other NPIs on this enrollment
Practice locations: Bonifay, FL
O20120221000281 FL Part a Provider - Critical Access Hospital 3375557887 Receives reassigned benefits from 2 practitioners
Practice locations: Bonifay, FL

National Provider Directory

Locations

2910 Hospital Dr
Ste A
Bonifay, FL 32425
Phone (850) 547-8118

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 4427 FL Yes
Critical Access Hospital 282NC0060X

Addresses

Primary practice location

2600 Hospital Drive
Bonifay, FL 32425

Mailing address

P.O. Box 188
Bonifay, FL 32425
Phone (850) 547-8015

Other identifiers

IdentifierTypeStateIssuer
010103600MedicaidFL
010103602MedicaidFL
CH0342OtherMEDICARE RAIL ROAD
428OtherFLBC/BS PROVIDER NUMBER

Other names

  • Doctors Memorial Hospital Doing business as

Other providers in Bonifay, FL

All providers in Bonifay, FL · Critical Access Hospital in Florida

Sources for this page

Verify at the official NPI Registry.