NPIMap

Organization Active NPI

D. W. McMillan Memorial Hospital

  • General Acute Care Hospital
  • Brewton, AL
National Provider Identifier
1609811538
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
11799 Issued in AL
Legal business name
D. W. MCMILLAN MEMORIAL HOSPITAL
Practice address
1301 Belleville Ave
Brewton, AL 36426-1306
Phone
(251) 867-8061
Fax
(251) 809-8137
NPI assigned
Jun 17, 2006
Last updated
Sep 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Authorized official

Name
Stacy Hines
Title
Administrator
Phone
(251) 809-8429

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 11799 AL Primary

Addresses

Primary practice location

1301 Belleville Ave
Brewton, AL 36426-1306

Mailing address

1301 Belleville Ave
P. O. Box 908
Brewton, AL 36426-1306
Phone (251) 867-8061

Other identifiers 1

IdentifierTypeStateIssuer
HOS0099HMedicaidAL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dwmccd@echa.cernerdirect.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050627001338 AL Part A Provider - Hospital 3072558378 Practice locations: Brewton, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609811538. Details of each certification follow.

Hospital certification: CCN 010099

Legal name
D.W. MCMILLAN MEMORIAL HOSPITAL
Doing business as
D W MCMILLAN MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Sep 12, 2024
Beds
65
Ownership / control type
Hospital district or authority
Most recent change of ownership
Jul 1, 2005 (3 total)
Organization structure
OtherNon-profit
Incorporated
Apr 11, 1995 in AL
Enrollment address
1301 Belleville Ave
Brewton, AL 36426-1306
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

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

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
D W McMillan Memorial HospitalCCN 010099 · All quality measures
Overall star rating
1 of 5
Type
Acute Care Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Escambia Cod W McMillan6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Interoperability endpoints

  • Direct secure messaging: sharigel@echca.cernerdirect.com

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
Susan S Hines Individual Corporate DirectorChief Operating Officer Sep 1, 2021
Jeffrey Booth Individual Corporate OfficerCeo Sep 1, 2021 100%
Stephen Fischer Individual Corporate OfficerCfo Sep 1, 2021
W-2 Managing Employee Sep 1, 2021

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Flomaton Medical CenterFlomaton, AL, CCN 013440 Rural health clinic 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jul 1, 2005
Jul 1, 2005
D W McMillan Medical CenterBrewton, AL, CCN 013498 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2005

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 8

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 114

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

View all 114

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663718400000",
    "number": "1609811538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 BELLEVILLE AVE",
            "address_2": "P. O. BOX 908",
            "city": "BREWTON",
            "state": "AL",
            "postal_code": "364261306",
            "telephone_number": "251-867-8061",
            "fax_number": "251-809-8137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 BELLEVILLE AVE",
            "city": "BREWTON",
            "state": "AL",
            "postal_code": "364261306",
            "telephone_number": "251-867-8061",
            "fax_number": "251-809-8137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D. W. MCMILLAN MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A",
        "authorized_official_last_name": "HINES",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "251-809-8429"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "AL",
            "license": "11799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HOS0099H",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dwmccd@echa.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "D W McMillan Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1301 Belleville Ave",
            "city": "Brewton",
            "state": "AL",
            "country_code": "US",
            "postal_code": "364261306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brewton, AL

Sources for this page

Verify at the official NPI Registry.