NPIMap

Organization Active NPI

Geneva County Healthcare Authority, Inc.

  • Rural Health Clinic/Center
  • Samson, AL
National Provider Identifier
1508440488
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GENEVA COUNTY HEALTHCARE AUTHORITY, INC.
Practice address
98 E Morris St
Samson, AL 36477-1229
Phone
(334) 898-2728
Fax
(334) 898-2774
NPI assigned
May 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

Authorized official

Name
Janet Smith
Title
Ceo
Phone
(334) 684-3655

Specialties & licenses 1

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

Addresses

Primary practice location

98 E Morris St
Samson, AL 36477-1229

Mailing address

1200 W Maple Ave
Geneva, AL 36340-1642
Phone (334) 684-3655

Other names 1

  • Samson Rural Health Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210601000329 AL Part A Provider - Rural Health Clinic 0244222487 Practice locations: Samson, AL

Rural health clinic certification: CCN 018502

Legal name
GENEVA COUNTY HEALTHCARE AUTHORITY INC
Doing business as
SAMSON RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 18, 2023
Last certification
Dec 20, 2022
Ownership / control type
2B
Organization structure
OtherNon-profit
Incorporated
Feb 20, 1951 in AL
Enrollment address
98 E Morris St
Samson, AL 36477-1229
Related CCNs
010062

Other NPIs with the same Medicare PAC ID 5

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D1030889Samson Rural Health Clinic98 E Morris St, Samson, AL 36477Provider-performed microscopySep 19, 2026

National Provider Directory

National Provider Directory
Tax ID family
Geneva County Healthcare Authority Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Member organizations 2

Organizations listed as members of this organization 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
Geneva County Healthcare Authority Inc Organization, Geneva, AL 5% Or Greater Direct Ownership Interest Nov 1, 2019 100%
Operational/Managerial Control Nov 1, 2019 100%
Janet E Smith Individual W-2 Managing EmployeeCeo Jul 3, 2020 100%
David H Arnold Individual Corporate DirectorDirector Apr 13, 2015 11.11%
Jean a Turner Individual Corporate DirectorDirector Apr 12, 2021 11.11%
Lenora Simmons Individual Corporate OfficerVice-Chairman of Board of Directors Jan 14, 2021 11.11%
Corporate DirectorDirector Jul 22, 2013 11.11%
Jeremy L Williams Individual Corporate OfficerSecretary of Board of Directors Jan 14, 2021 11.11%
Corporate DirectorDirector Oct 13, 2014 11.11%
Phillip Durant Individual Corporate DirectorDirector Sep 9, 2013 11.11%
Jonathan D Markham Individual Corporate OfficerChairman of Board of Directors Jan 14, 2021 11.11%
Corporate DirectorDirector May 12, 2014 11.11%
Dorthea Jay Individual Corporate DirectorDirector Oct 1, 2016 11.11%
John Box Individual Corporate DirectorDirector Nov 25, 2013 11.11%

Owners & managing parties with NPI records 7

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Wiregrass Medical CenterGeneva, AL, CCN 011309 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 17, 2013
Wiregrass Medical CenterGeneva, AL, CCN 01Z309 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 17, 2013

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620345600000",
    "number": "1508440488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W MAPLE AVE",
            "city": "GENEVA",
            "state": "AL",
            "postal_code": "363401642",
            "telephone_number": "334-684-3655",
            "fax_number": "334-684-0299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 E MORRIS ST",
            "city": "SAMSON",
            "state": "AL",
            "postal_code": "364771229",
            "telephone_number": "334-898-2728",
            "fax_number": "334-898-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENEVA COUNTY HEALTHCARE AUTHORITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-07",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "334-684-3655"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samson Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Samson, AL

Sources for this page

Verify at the official NPI Registry.