NPIMap

Organization Active NPI

HH Health System - Jackson LLC

Doing business as Highlands Family Medicine LLC

  • Rural Health Clinic/Center
  • Scottsboro, AL
National Provider Identifier
1497449334
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HH HEALTH SYSTEM - JACKSON LLC
Doing business as
Highlands Family Medicine LLC
Practice address
507 Harley St
Scottsboro, AL 35768-4218
Phone
(256) 259-0061
Fax
(256) 259-0668
NPI assigned
Jun 5, 2023
Last updated
Jun 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Authorized official

Name
John Carrier
Title
Cfo
Phone
(256) 218-3680

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

507 Harley St
Scottsboro, AL 35768-4218

Mailing address

PO Box 1050
Scottsboro, AL 35768-1050

Other names 1

  • Highlands Family Medicine LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230630002963 AL Part A Provider - Rural Health Clinic 1951788769 Practice locations: Scottsboro, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497449334. Details of each certification follow.

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
LLCNon-profit
Incorporated
Aug 4, 2021 in AL
Enrollment address
507 Harley St
Scottsboro, AL 35768-4218
Related CCNs
010061

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

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Tax ID family
HH Health System - Jackson LLC7 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.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Karen Grider Individual Corporate DirectorExecutive Director May 22, 2024 100%
W-2 Managing EmployeeExecutive Director May 22, 2024 100%
Operational/Managerial ControlExecutive Director May 22, 2024 100%
The Health Care Authority of the City of Huntsville Organization, Huntsville, AL 5% Or Greater Direct Ownership Interest Dec 1, 2021 100%
Andrew Wenning Individual Corporate DirectorDirector of Finance May 22, 2024 100%
W-2 Managing EmployeeDirector of Finance May 22, 2024 100%
Operational/Managerial ControlDirector of Finance May 22, 2024 100%

Owners & managing parties with NPI records 3

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

Facilities with the same owner 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685923200000",
    "number": "1497449334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1050",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357681050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 HARLEY ST",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357684218",
            "telephone_number": "256-259-0061",
            "fax_number": "256-259-0668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HH HEALTH SYSTEM - JACKSON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-05-26",
        "status": "A",
        "authorized_official_last_name": "CARRIER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "256-218-3680"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Highlands Family Medicine LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Scottsboro, AL

Sources for this page

Verify at the official NPI Registry.