HH Health System - Jackson LLC
Organization Active NPI Rural Health Clinic/Center · Scottsboro, AL
NPI 1497449334 · NPPES record last updated Jun 5, 2023
Key facts
- NPI
- 1497449334
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- HH HEALTH SYSTEM - JACKSON LLC
- Practice address
- 507 Harley St
Scottsboro, AL 35768-4218 - Phone
- (256) 259-0061
- Fax
- (256) 259-0668
- NPI assigned
- Jun 5, 2023
- Organization subpart
- No
Authorized official
- Name
- John Carrier
- Title
- Cfo
- Phone
- (256) 218-3680
Owners & managing parties with NPI records 3
Other NPIs with the same Medicare PAC ID 6
Corporate family (same tax ID) 6
Member of 1
Related certifications (CCN) 1
Facilities with the same owner 13
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Rural health clinic certification: CCN 018504
- Legal name
- HH HEALTH SYSTEM - JACKSON LLC
- Doing business as
- HIGHLANDS FAMILY MEDICINE LLC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Dec 20, 2023
- Last certification
- Dec 20, 2023
- Ownership / control type
- Non-profit – church related
- Organization structure
- LLC · Non-profit
- Incorporated
- Aug 4, 2021 in AL
- Enrollment address
- 507 Harley St
Scottsboro, AL 35768-4218 - Related CCNs
- 010061
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Karen Grider |
Corporate Director |
May 22, 2024 | 100% |
| W-2 Managing Employee |
May 22, 2024 | 100% | |
| Operational/Managerial Control |
May 22, 2024 | 100% | |
| The Health Care Authority of the City of Huntsville |
5% Or Greater Direct Ownership Interest | Dec 1, 2021 | 100% |
| Andrew Wenning |
Corporate Director |
May 22, 2024 | 100% |
| W-2 Managing Employee |
May 22, 2024 | 100% | |
| Operational/Managerial Control |
May 22, 2024 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230630002963 | AL | Part a Provider - Rural Health Clinic | 1951788769 | Practice locations: Scottsboro, AL |
National Provider Directory
- Tax ID family
- HH Health System - Jackson LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
507 Harley St
Scottsboro, AL 35768-4218
Mailing address
PO Box 1050
Scottsboro, AL 35768-1050
Other names
- Highlands Family Medicine LLC
Other providers in Scottsboro, AL
- Heartlite Hospice, Inc.
- Corey Hebert
- Lawrence J Herberholz
- HH Health System - Jackson LLC
- HH Health System - Jackson LLC
- HH Health System - Jackson LLC
- HH Health System - Jackson LLC
- HH Health System - Jackson LLC
- HH Health System - Jackson LLC
- Rebecca Hicks
All providers in Scottsboro, AL · Rural Health Clinic/Center in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2023. 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.