Clinton and Hickman County Hospital, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

100180 Issued in KY

Legal business name

CLINTON AND HICKMAN COUNTY HOSPITAL, INC.

Practice address

366 S Washington St
Clinton, KY 42031-1324

Phone

(270) 653-2461

Fax

(270) 653-4162

NPI assigned

Dec 4, 2006

Last updated

Apr 6, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. William B. Little, ADMINISTRATOR

Title

Administraot

Phone

(270) 653-2461

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467520650. Details of each certification follow.

• CCN 185326 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 185326

Legal name

CLINTON AND HICKMAN COUNTY HOSPITAL, INC.

Doing business as

CLINTON-HICKMAN COUNTY SNF/ICF

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Mar 1, 1992

Last certification

Apr 25, 2024

Beds

46

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Enrollment address

366 S Washington St
Clinton, KY 42031-1324

Nursing home name

CLINTON-HICKMAN COUNTY NURSING FACILITY

Listed as

Clinton-Hickman County Nursing FacilityCCN 185326 · All quality measures

Overall star rating

4 of 5

Health inspections

3 of 5

Staffing

5 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Mar 1, 1992

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

4637.1 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Locations

All disclosed owners & managing parties 9

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

Owners & managing parties with NPI records 1

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

• Richard Darren Stone, D.O.

  • Family Medicine Physician
  • Mayfield, KY
  • NPI 1508178336

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David R Zetter, MD

  • General Practice Physician
  • Arlington, KY
  • NPI 1598711756
  NPD (past)

Affiliated clinicians 1

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

• Richard Darren Stone, D.O.

  • Family Medicine Physician
  • Mayfield, KY
  • NPI 1508178336

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333670400000",
    "number": "1467520650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 S WASHINGTON ST",
            "city": "CLINTON",
            "state": "KY",
            "postal_code": "420311324",
            "telephone_number": "270-653-2461",
            "fax_number": "270-653-4162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 S WASHINGTON ST",
            "city": "CLINTON",
            "state": "KY",
            "postal_code": "420311324",
            "telephone_number": "270-653-2461",
            "fax_number": "270-653-4162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTON AND HICKMAN COUNTY HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2012-04-06",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "ADMINISTRAOT",
        "authorized_official_telephone_number": "270-653-2461",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KY",
            "license": "100180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Shawn Boaz, R.PH
• Jo Ann N Bolli, M.D.
• John Garland Byassee, PHARM.D.
• Rick Canty, D.M.D.
• Jessica Brook Charlton, L.P.C.A.
• Clinton Dental Clinic,Inc.
• Clinton Pharmacy LLC
• Clinton Pharmacy LLC (Clinton Pharmacy)
• Clinton-Hickman County Ambulance Service Inc
• Communtiy Healthcare of Western Kentucky LLC

• Skilled Nursing Facility in Clinton, KY
• Providers in Clinton, KY by specialty
• Skilled Nursing Facility in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.