NPIMap

Organization Active NPI

Rural Health Medical Program, Inc.

  • Federally Qualified Health Center (FQHC)
  • Marion, AL
National Provider Identifier
1437238151
Registry record updated Dec 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
RURAL HEALTH MEDICAL PROGRAM, INC.
Practice address
1310 Washington Street
Marion, AL 36756-3218
Phone
(334) 683-2073
Fax
(334) 683-2077
NPI assigned
Nov 3, 2006
Organization subpart
Yes
Parent organization
RURAL HEALTH MEDICAL PROGRAM, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 21, 2010

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

Authorized official

Name
Ms. Patricia Gibson
Title
Ceo
Phone
(334) 874-7428

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X AL Primary

Addresses

Primary practice location

1310 Washington Street
Marion, AL 36756-3218

Mailing address

P O Box 2213
228 Selma Avenue
Selma, AL 36702-2213
Phone (334) 874-4728

Other identifiers 2

IdentifierTypeStateIssuer
630000008MedicaidAL
011914OtherALMEDICARE ID - TYPE UNSPECIFIED

Other names 1

  • Marion Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040506001178 AL Part B Supplier - Clinic/Group Practice 0143219196 Receives reassigned benefits from 42 practitioners
10 other NPIs on this enrollment
Practice locations: Demopolis, AL; Marion, AL; Monroeville, AL; Pine Apple, AL; Selma, AL; Thomaston, AL; Uniontown, AL; Vredenburgh, AL…
O20101118000089 AL Part A Provider - Federally Qualified Health Center (FQHC) 0143219196 Practice locations: Marion, AL
O20200407001242 AL MDPP Supplier - in-Person MDPP Supplier 0143219196 8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Camden, AL; Demopolis, AL; Marion, AL; Monroeville, AL; Pine Apple, AL; Selma, AL; Thomaston, AL; Uniontown, AL

Federally qualified health center certification: CCN 011914

Legal name
RURAL HEALTH MEDICAL PROGRAM, INC.
Doing business as
MARION HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 10, 2001
Last certification
Dec 10, 2001
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 30, 1978 in AL
Enrollment address
1310 Washington St
Marion, AL 36756-3218

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 10

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D0996111Marion Health Center1310 Washington Street, Marion, AL 36756Provider-performed microscopyFeb 10, 2028

National Provider Directory

National Provider Directory
Tax ID family
Vredenburgh Health Center10 organizations share this tax ID, including this one
Part of
Vredenburgh Health Center

Other organizations with this tax ID 9

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

Locations

1310 Washington St
Marion, AL 36756
Phone (334) 683-2073

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Don King Individual Corporate Director Jul 1, 2022
Brenda Blevins Individual Corporate Officer Oct 1, 2016
Earnestine Burrell Individual Corporate Officer May 1, 2017
Keshee Danee Smith Individual Corporate Officer Mar 7, 2016
Latoya Freeman Individual W-2 Managing EmployeeHR Director Oct 31, 2016

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Uniontown Health ServicesUniontown, AL, CCN 011837 Federally qualified health center Operational/Managerial Control Jul 18, 2011
Pine Apple Health CenterPine Apple, AL, CCN 011836 Federally qualified health center Operational/Managerial Control Sep 17, 2010

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 44

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

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292889600000",
    "number": "1437238151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 2213",
            "address_2": "228 SELMA AVENUE",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367022213",
            "telephone_number": "334-874-4728",
            "fax_number": "334-874-7435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 WASHINGTON STREET",
            "city": "MARION",
            "state": "AL",
            "postal_code": "367563218",
            "telephone_number": "334-683-2073",
            "fax_number": "334-683-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RURAL HEALTH MEDICAL PROGRAM, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RURAL HEALTH MEDICAL PROGRAM, INC.",
        "enumeration_date": "2006-11-03",
        "last_updated": "2010-12-21",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "334-874-7428",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630000008",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID - TYPE UNSPECIFIED",
            "identifier": "011914",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marion Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marion, AL

Sources for this page

Verify at the official NPI Registry.