NPIMap

Organization Active NPI

Hospital Authority of Mitchell County

  • Skilled Nursing Facility
  • Camilla, GA
National Provider Identifier
1609965060
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1-101-125 Issued in GA
Legal business name
HOSPITAL AUTHORITY OF MITCHELL COUNTY
Practice address
37 S Ellis St
Camilla, GA 31730-1812
Phone
(229) 336-8377
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Authorized official

Name
Mr. Gregory S. Hembree
Title
Cfo
Phone
(229) 228-2880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1-101-125 GA Primary

Addresses

Primary practice location

37 S Ellis St
Camilla, GA 31730-1812

Mailing address

920 Cairo Rd
Thomasville, GA 31792-4255
Phone (229) 228-8800

Other names 1

  • Mitchell County Nursing Homes Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080310000658 GA Part A Provider - Skilled Nursing Facility 6002724598 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Camilla, GA; Pelham, GA

Skilled nursing facility certification: CCN 115266

Legal name
HOSPITAL AUTHORITY OF MITCHELL COUNTY
Doing business as
MITCHELL COUNTY NURSING HOMES
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 1979
Last certification
May 11, 2023
Beds
156
Ownership / control type
County
Multi-facility organization
John D Archbold Memorial Hospital
Organization structure
OtherNon-profit
Enrollment address
37 S Ellis St
Camilla, GA 31730-1812
Nursing home name
ARCHBOLD LIVING CAMILLA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Archbold Living CamillaCCN 115266
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
4 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Government - County
Certified
Jul 1, 1979
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
156136.4 residents per day on average
Special focus status
SFF Candidate
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
2Fines totaling $17,345

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 31

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

NameRoleSinceShare
Organization, Albany, GA LLC Indirect Ownership Interest Jan 1, 2020
Andrea Kidd Collins Individual Corporate OfficerBoard Member Feb 25, 2025
James Womack Individual Corporate OfficerVP Critical Access/Post Acute Dec 19, 2020
Adp of the SNF Dec 1, 2023
Craig R Wentworth Individual Corporate DirectorBoard Member Oct 1, 2021
Patricia L Barrett Individual Operational/Managerial Control Dec 16, 1991
Carla Pearce Individual Corporate OfficerChief Accounting Officer Oct 1, 2021
Brian J Szwarc Individual Corporate DirectorBoard Member Oct 1, 2021
Organization, Maitland, FL LLC Adp of the SNF Apr 7, 2025
Sina E. Griffith Individual Corporate DirectorBoard Member Oct 1, 2021
Jason Odell Burnette Individual Corporate OfficerBoard Member Mar 1, 2025
Organization, San Diego, CA LLC Adp of the SNF Apr 10, 2025
Josh David Simmons Individual Corporate DirectorBoard Member Jan 1, 2023
Organization, Albany, GA Adp of the SNF Apr 11, 2025
John D Archbold Memorial Hospital Inc Organization, Thomasville, GA Corporation Operational/Managerial Control Oct 1, 1990
Adp of the SNF Oct 1, 1990
Henry a. Stone Individual Corporate DirectorBoard Member Oct 1, 2021
Timothy Eric Ward Individual Corporate OfficerBoard Member Feb 25, 2025
Karen L Bramblett Individual Corporate DirectorBoard Member Jan 1, 2023
Darcy M Craven Individual Corporate DirectorBoard Member Oct 1, 2021
Joe S Carnline Individual Corporate DirectorBoard Member Jan 1, 2023
Ashley T. Cason Individual Corporate DirectorBoard Member Jan 1, 2023
Libby M. Gardner Individual Corporate OfficerSNF Administrator Jul 5, 2022
Adp of the SNF Jul 5, 2022
Christopher L Daniels Individual Corporate OfficerBoard Member Mar 1, 2025
Stephen a Rubendall Individual Adp of the SNF Apr 10, 2025
Indirect Ownership Interest Oct 1, 2009
Marvin E. Dawson Individual Corporate DirectorBoard Member Jan 1, 2023
Organization, Nashville, TN LLC Adp of the SNF Apr 11, 2025
William G Hamil Individual Corporate DirectorBoard Member Jan 28, 2023
Jami Porter Individual Corporate DirectorBoard Member Jan 1, 2023
Individual Adp of the SNF Oct 1, 2020
Gregory Hembree Individual Corporate OfficerSenior Vice President/Cfo Dec 5, 2016
Jacquelyn V. Santoro Individual Corporate DirectorBoard Member Jan 1, 2023
Jason M Nesmith Individual Corporate DirectorBoard Member Oct 1, 2021

Owners & managing parties with NPI records 14

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

View all 14

Practitioners & affiliated clinicians

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": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1609965060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 CAIRO RD",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317924255",
            "telephone_number": "229-228-8800",
            "fax_number": "229-228-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 S ELLIS ST",
            "city": "CAMILLA",
            "state": "GA",
            "postal_code": "317301812",
            "telephone_number": "229-336-8377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITAL AUTHORITY OF MITCHELL COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "HEMBREE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "229-228-2880",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "1-101-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mitchell County Nursing Homes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Camilla, GA

Sources for this page

Verify at the official NPI Registry.