Cameron Memorial Community Hospital Inc
Organization Active NPI Rural Health Clinic/Center · Angola, IN
NPI 1417440264 · NPPES record last updated Jul 7, 2025
Key facts
- NPI
- 1417440264
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- CAMERON MEMORIAL COMMUNITY HOSPITAL INC
- Practice address
- 306 E Maumee St Ste 101
Angola, IN 46703-2037 - Phone
- (260) 667-5670
- Fax
- (260) 667-5680
- NPI assigned
- Jun 7, 2018
- Organization subpart
- No
Authorized official
- Name
- Angela Logan
- Title
- Ceo
- Phone
- (260) 667-5133
Owners & managing parties with NPI records 9
-
Charles Maclean, MD
-
Todd C Rumsey, MD
Owned or controlled facilities with NPI records 5
Other NPIs on the same Medicare enrollment 6
Other NPIs with the same Medicare PAC ID 7
Corporate family (same tax ID) 6
Related certifications (CCN) 1
Facilities with the same owner 4
Practitioners 83
-
Trisha D Brown, CNM, WHNP
-
Jessica Baker, NP
-
Kelly Bireley, FNP-BC
-
Todd D Brandon, M.D.
-
Christy R. Brown, CRNA
-
Jeanette Cochran, N.P.
-
Simon Peter Crass, M.D.
-
Nicole A Deller, PMHNP
-
Patricia Dingman, FNP-C
-
Joseph W Egbert, CRNA
-
Laura M Folds, N.P.
-
Matthew H Franz, MD
-
Brandy M. German, NP-C
-
Jordan Geroski, DO
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D2139026 | Cameron OB/GYN | Provider-performed microscopy | Oct 29, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IN
Rural health clinic certification: CCN 158546
- Legal name
- CAMERON MEMORIAL COMMUNITY HOSPITAL INC
- Doing business as
- CAMERON OB/GYN
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Nov 25, 2019
- Last certification
- Nov 25, 2019
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 306 E Maumee St
Ste 101
Angola, IN 46703-2037 - Related CCNs
- 151315
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| Carrie Vollmer-Sanders |
Corporate Officer | Jun 3, 2025 | |
| Todd C Rumsey |
Corporate Officer |
Sep 30, 2013 | |
| Ann Rice |
Corporate Officer | Apr 25, 2023 | |
| Wendy Jean Stamper |
Corporate Director | Jan 1, 2019 | |
| Jonathan Orlando Cress |
Corporate Officer | Apr 25, 2023 | |
| Michael Connell |
Corporate Officer | Apr 25, 2023 | |
| Scott Gruner |
Corporate Officer | Jun 3, 2025 | |
| Janelle Sponsler |
W-2 Managing Employee |
May 1, 2021 | |
| Luke Andrews |
Corporate Officer | Jun 3, 2025 | |
| Angela M Logan |
Corporate Officer |
May 1, 2021 | |
| Andrew Kleber |
Corporate Officer |
Jun 3, 2025 | |
| Donna K Elbrecht |
Corporate Officer | Apr 25, 2023 | |
| Kendra Klink |
Corporate Officer | Jun 3, 2025 | |
| Cameron Memorial Community Hospital Inc |
5% Or Greater Direct Ownership Interest | Apr 25, 2023 | 100% |
| John McCoy |
Corporate Officer |
Sep 30, 2013 | |
| Charles L Maclean |
Corporate Officer | Jun 3, 2025 |
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Cameron Memorial Community Hospital Inc |
Hospital | Operational/Managerial Control | Jan 1, 1989 |
| Cameron Jointaccess Ortho & Urgent |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Apr 25, 2023 |
| Cameron Family Medicine - North |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Oct 1, 2021 |
| Cameron Family Medicine Fremont |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040323001008 | IN | Part B Supplier - Clinic/Group Practice | 9234020835 |
Receives reassigned benefits from 136 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Angola, IN; Fremont, IN; Fort Wayne, IN |
| O20180811000170 | IN | Part a Provider - Rural Health Clinic | 9234020835 | Practice locations: Angola, IN |
National Provider Directory
- Tax ID family
- Cameron Memorial Community Hospital Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
306 E Maumee St Ste 101
Angola, IN 46703-2037
Mailing address
416 E Maumee St
Angola, IN 46703-2001
Phone (260) 667-5133
Other names
- CAMERON OB/GYN
Other providers in Angola, IN
- Trisha D Brown
- Dianna Burns
- Brooke Butler
- Cameron Medical Outreach, Inc
- Cameron Memorial Community Hospital Inc
- Cameron Memorial Community Hospital Inc
- Cameron Memorial Community Hospital, Inc
- Cameron Memorial Community Hospital, Inc
- Cameron Memorial Community Hospital, Inc
- Cameron Memorial Community Hospital, Inc
All providers in Angola, IN · Rural Health Clinic/Center in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.