Appalachian Regional Healthcare Inc
Organization Active NPI Rural Health Clinic/Center · South Williamson, KY
NPI 1487762399 · NPPES record last updated Sep 20, 2024
Key facts
- NPI
- 1487762399
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- APPALACHIAN REGIONAL HEALTHCARE INC
- Practice address
- 306 Hospital Drive
South Williamson, KY 41503 - Phone
- (606) 237-1757
- NPI assigned
- Aug 29, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Hollie Harris
- Title
- President and Ceo
- Phone
- (859) 226-2511
Owners & managing parties with NPI records 2
-
Dustin Scott Campbell, M.D.
-
Larry B Francis, MD
Other NPIs on the same Medicare enrollment 35
Member of 1
Related certifications (CCN) 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KY
Rural health clinic certification: CCN 188509
- Legal name
- APPALACHIAN REGIONAL HEALTHCARE INC
- Doing business as
- ARH TUG VALLEY MEDICAL ASSOCIATES
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jun 1, 2017
- Last certification
- Jan 7, 2020
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jun 28, 1963 in KY
- Enrollment address
- 306 Hospital Dr
South Williamson, KY 41503-4095 - Related CCNs
- 180069
All disclosed owners & managing parties 21
| Name | Role | Since | Share |
|---|---|---|---|
| Gregory a Wilson |
Corporate Director |
Nov 8, 2019 | |
| Hollie Harris |
Corporate Officer |
May 10, 2021 | |
| Gregory Couch |
Corporate Director |
Nov 8, 2013 | |
| Maria Benoit Braman |
Corporate Officer |
Mar 7, 2016 | |
| Andrea Massey |
Corporate Director |
Nov 4, 2016 | |
| Julie Rose |
Corporate Director |
Nov 5, 2014 | |
| Christi Lee |
Corporate Officer |
Nov 5, 2021 | |
| Joann Anderson |
Corporate Director | Nov 2, 2017 | |
| Gregory Pauley |
Corporate Director |
Nov 5, 2010 | |
| Dustin S Campbell |
Corporate Director |
Nov 11, 2022 | |
| Samuel Dunn |
Corporate Director |
Nov 5, 2021 | |
| Jeffrey Hollon |
Corporate Director |
Nov 2, 2012 | |
| Larry B Francis |
Corporate Director |
Nov 2, 2017 | |
| Randall Evans |
Corporate Director |
Nov 8, 2013 | |
| Onzie Sizemore |
Corporate Director |
Nov 5, 2014 | |
| Karen Newman |
Corporate Director |
Nov 11, 2022 | |
| Theodore T Myre |
Corporate Director |
Nov 2, 2017 | |
| Susan Renae Neace |
W-2 Managing Employee |
Jan 3, 2005 | |
| Michael Rust |
Corporate Director |
Nov 8, 2019 | |
| Edith Kelly |
Corporate Director |
Nov 11, 2022 | |
| Ken Allman |
Corporate Director | Nov 8, 2019 |
All facility ownership & control disclosures 24
| Facility | Type | Role | Since |
|---|---|---|---|
| Harlan Arh Hospital |
Hospital | 5% Or Greater Direct Ownership Interest Other |
Jan 1, 1966 Jan 1, 1966 |
| Mary Breckinridge Arh Hospital |
Hospital | Operational/Managerial Control (100%) | Sep 7, 2011 |
| Barbourville Arh Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | May 31, 2011 |
| Barbourville Arh Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | May 31, 2011 |
| Arh Our Lady of the Way |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | May 31, 2011 |
| Arh Our Lady of the Way |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | May 31, 2011 |
| Highlands Arh Regional Medical Center |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jul 19, 2013 |
| Highlands Arh Regional Medical Center |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jul 19, 2013 |
| Paintsville Arh Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jul 19, 2013 |
| Arh Advanced Care - Big Sandy |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | May 5, 2021 |
| Arh Advance Care-Ky River |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | May 5, 2021 |
| Mary Breckinridge Arh Hospital |
Hospital | Operational/Managerial Control | Sep 7, 2011 |
| Appalachian Regional Healthcare Inc |
Home health agency | 5% Or Greater Indirect Ownership Interest | Sep 10, 2008 |
| Mary Breckinridge Arh Home Health Agency |
Home health agency | 5% Or Greater Direct Ownership Interest (100%) | May 31, 2011 |
| Highlands Arh Home Health Agency |
Home health agency | 5% Or Greater Direct Ownership Interest (100%) | Jul 19, 2013 |
| Hyden Arh Clinic |
Rural health clinic | Operational/Managerial Control (100%) | Sep 7, 2011 |
| Arh Cumberland Valley Medical |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | May 31, 2011 |
| Arh Cumberland Valley Medical and Surgical Associates |
Rural health clinic | Operational/Managerial Control (100%) | May 31, 2011 |
| Arh Women'S and Family Health Center - Middlesboro |
Rural health clinic | Operational/Managerial Control (100%) | Jun 8, 2018 |
| Arh Primary Care Associates - NJ |
Rural health clinic | Operational/Managerial Control (100%) | May 31, 2011 |
| Arh Primary Care Associates - Ni |
Rural health clinic | Operational/Managerial Control (100%) | May 31, 2011 |
| Arh Cumberland Valley Medical and Specialty Associates |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | May 31, 2011 |
| Arh Medical and Specialty Associates-Highlands |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jul 19, 2013 |
| Paintsville Arh Medical and Specialty Associates |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | May 1, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031125000520 | KY | Part B Supplier - Clinic/Group Practice | 0840107835 |
Receives reassigned benefits from 432 practitioners 48 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
| O20170712000363 | KY | Part a Provider - Rural Health Clinic | 0840107835 | Practice locations: South Williamson, KY |
National Provider Directory
Locations
306 Hospital Dr
South Williamson, KY 41503
Phone (606) 237-1700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
306 Hospital Drive
South Williamson, KY 41503
Mailing address
306 Hospital Dr
South Williamson, KY 41503-4095
Phone (606) 237-1757
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5301025000 | Medicaid | WV | |
| 7100371150 | Medicaid | KY |
Other names
- ARH Tug Valley Medical Associates
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
Other providers in South Williamson, KY
- Augusto T Abad
- Ahsen Ali MD PSC
- Ahsen Ali MD PSC
- Ahsen Ali MD PSC
- Tammy Renee Allen
- Appalachian Regional Healthcare Inc
- Appalachian Regional Healthcare, Inc.
- Appalachian Regional Healthcare, Inc.
- Appalachian Regional Healthcare, Inc.
- Appalachian Regional Healthcare, Inc.
All providers in South Williamson, KY · Rural Health Clinic/Center in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2024. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.