NPIMap

Organization Active NPI

Cameron Memorial Community Hospital, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Angola, IN
National Provider Identifier
1457577488
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
CAMERON MEMORIAL COMMUNITY HOSPITAL, INC.
Practice address
416 E Maumee St
Angola, IN 46703-2015
Phone
(260) 665-2141
Fax
(260) 665-7886
NPI assigned
Apr 18, 2007
Last updated
May 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Authorized official

Name
Carlos Alcazar
Title
VP/Cfo
Phone
(260) 667-5133

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

Addresses

Primary practice location

416 E Maumee St
Angola, IN 46703-2015

Mailing address

416 E Maumee St
Angola, IN 46703-2015
Phone (260) 665-2141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081023000562 IN Part A Provider - Critical Access Hospital 9234020835 1 other NPI on this enrollment
Practice locations: Angola, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1457577488. Details of each certification follow.

Hospital certification: CCN 15Z315

Legal name
CAMERON MEMORIAL COMMUNITY HOSPITAL INC
Doing business as
CAMERON MEMORIAL COMMUNITY HOSPITAL INC
Organization structure
CorporationNon-profit
Incorporated
Sep 1, 2000 in IN
Enrollment address
416 E Maumee St
Angola, IN 46703-2015
Other Hospital Practice Location

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

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 1

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

National Provider Directory

National Provider Directory
Tax ID family
Cameron Memorial Community Hospital Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Todd C Rumsey Individual Corporate OfficerTreasurer Sep 30, 2013
Wendy Jean Stamper Individual Corporate DirectorController Feb 1, 2020
Deborah E McHenry Individual Corporate OfficerChair Sep 30, 2013
Janelle Sponsler Individual W-2 Managing EmployeeDirector of PT Accting Oct 30, 2020
Jennifer L Danic Individual Corporate OfficerImmediate Past Chair Sep 30, 2013
Teresa L King Individual Corporate OfficerSecretary Sep 30, 2013
Angela M Logan Individual Corporate OfficerCeo May 28, 2019
Andrew Michael Aldred Individual Corporate OfficerCoo Feb 1, 2020
Cameron Memorial Community Hospital Inc Organization, Angola, IN Corporation Operational/Managerial Control Jan 1, 1989
John McCoy Individual Corporate OfficerVice Chair Sep 30, 2013

Owners & managing parties with NPI records 9

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Cameron Jointaccess Ortho & UrgentAngola, IN, CCN 158545 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 25, 2023
Cameron OB/GYNAngola, IN, CCN 158546 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 25, 2023
Cameron Family Medicine - NorthAngola, IN, CCN 158570 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2021
Cameron Family Medicine FremontFremont, IN, CCN 158571 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2023

Owned or controlled facilities with NPI records 5

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

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Affiliated clinicians 3

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

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621382400000",
    "number": "1457577488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 E MAUMEE ST",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032015",
            "telephone_number": "260-665-2141",
            "fax_number": "260-665-7886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 E MAUMEE ST",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032015",
            "telephone_number": "260-665-2141",
            "fax_number": "260-665-7886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMERON MEMORIAL COMMUNITY HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A",
        "authorized_official_last_name": "ALCAZAR",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "260-667-5133"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Angola, IN

Sources for this page

Verify at the official NPI Registry.