Organization Active NPI

Crowne Health Care of Fort Payne, LLC

  • Nursing Facility/Intermediate Care Facility
  • Fort Payne, AL
National Provider Identifier
1508825076
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
12527 Issued in AL
Legal business name
CROWNE HEALTH CARE OF FORT PAYNE, LLC
Practice address
403 13TH St NW
Fort Payne, AL 35967-3145
Phone
(256) 845-5990
Fax
(256) 845-5992
NPI assigned
Mar 22, 2006
Last updated
Mar 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Authorized official

Name
Noel Dunnam
Title
Cfo
Phone
(251) 743-7137

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 12527 AL Primary

Addresses

Primary practice location

403 13TH St NW
Fort Payne, AL 35967-3145

Mailing address

501 Whetstone St
Monroeville, AL 36460-2615
Phone (251) 743-3609

Other identifiers 1

IdentifierTypeStateIssuer
4757520SMedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031203000065 AL Part A Provider - Skilled Nursing Facility 0840195939 Practice locations: Fort Payne, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508825076. Details of each certification follow.

Skilled nursing facility certification: CCN 015156

Legal name
CROWNE HEALTH CARE OF FORT PAYNE, LLC
Doing business as
CROWNE HEALTH CARE OF FORT PAYNE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1977
Last certification
Nov 14, 2019
Beds
123
Ownership / control type
Corporation
Multi-facility organization
CROWNE HEALTH CARE
Most recent change of ownership
Nov 1, 2003
Organization structure
LLCProprietary
Incorporated
Sep 11, 2003 in AL
Enrollment address
403 13TH St NW
Fort Payne, AL 35967-3145
Nursing home name
CROWNE HEALTH CARE OF FT PAYNE
Affiliated entity
CROWNE HEALTH CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Crowne Health Care of Ft PayneCCN 015156 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 1, 1977
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
123109.4 residents per day on average
Chain
Crowne Health Care18 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

403 13th St NW
Fort Payne, AL 35967
Phone (256) 845-5990

Ownership & related parties

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.

NameRoleSinceShare
Crowne Management, LLC Organization, Monroeville, AL LLC Operational/Managerial Control Dec 10, 2009
Jennifer Jones McInnish Family Dynasty Trust #1 Organization, Monroeville, AL 5% Or Greater Indirect Ownership Interest Dec 31, 2016
Richard Bryan Jones Family Dynasty Trust #1 Organization, Monroeville, AL 5% Or Greater Indirect Ownership Interest Dec 31, 2016
John Todd Wilder Individual Corporate Director Dec 3, 2003
Crowne Operations, Inc Organization, Monroeville, AL Corporation 5% Or Greater Direct Ownership Interest Nov 1, 2003
Marcus F. Manning Individual Corporate Director Jun 11, 2015
Noel Dunnam Individual Corporate OfficerCfo/Secretary Jun 11, 2015 30%
Corporate DirectorCfo/Secretary Jun 11, 2015
Richard B. Jones Individual Corporate OfficerCeo/Vice President Jun 11, 2015
Corporate DirectorCeo/Vice President Dec 3, 2003
Felicia a. Case Individual W-2 Managing Employee Dec 24, 2021

Facilities with the same owner 17

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

View all 17

Practitioners & affiliated clinicians

Practitioners 3

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.

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1508825076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 WHETSTONE ST",
            "city": "MONROEVILLE",
            "state": "AL",
            "postal_code": "364602615",
            "telephone_number": "251-743-3609",
            "fax_number": "251-575-5618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 13TH ST NW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359673145",
            "telephone_number": "256-845-5990",
            "fax_number": "256-845-5992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROWNE HEALTH CARE OF FORT PAYNE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "DUNNAM",
        "authorized_official_first_name": "NOEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "251-743-7137"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "AL",
            "license": "12527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4757520S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Payne, AL

Sources for this page

Verify at the official NPI Registry.