Active NPI
TH Healthcare, LTD.
Doing business as Shelby Regional Medical Center
- General Acute Care Hospital
- Center, TX
National Provider Identifier
1639101108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Acute Care Hospital
- License
- 000423
- Legal business name
- TH HEALTHCARE, LTD.
- Doing business as
- Shelby Regional Medical Center
- Practice address
- 602 Hurst St
Center, TX 75935-3414 - Phone
- (936) 659-8278
- NPI assigned
- Jul 7, 2006
- Last updated
- Mar 24, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Zach Abercrombie
- Title
- Cfo
- Phone
- (205) 620-7095
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 000423 | TX | Primary |
Addresses
Primary practice location
602 Hurst St
Center, TX 75935-3414
Mailing address
PO Box 849775
Dallas, TX 75284-9775
Phone (936) 560-3186
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 114113 | Other | CHIP SUPERIOR HEALTH PLAN | |
| 133465808 | Medicaid | TX | |
| 000412 | Other | HUMANA | |
| HH0609 | Other | BCBS OF TEXAS | |
| 077747670 | Other | AETNA US HEALTHCARE | |
| 133465809 | Medicaid | TX | |
| 133465802 | Medicaid | TX | |
| 1734705 | Medicaid | LA |
Other names 1
- Shelby Regional Medical Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1639101108. Details of each certification follow.
Hospital certification: CCN 450839
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- SHELBY REGIONAL MEDICAL CENTER
- Certification status
- Terminated Involuntary: failure to meet health/safety requirements, Jul 10, 2013
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Oct 6, 2000
- Last certification
- Jun 6, 2013
- Beds
- 54 (46 certified)
- Ownership / control type
- Private (for profit)
- Most recent change of ownership
- Dec 1, 2007 (1 total)
- Facility address
- 602 Hurst Street
Center, TX 75935
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1648080000000",
"number": "1639101108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 849775",
"city": "DALLAS",
"state": "TX",
"postal_code": "752849775",
"telephone_number": "936-560-3186",
"fax_number": "936-598-4237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "602 HURST ST",
"city": "CENTER",
"state": "TX",
"postal_code": "759353414",
"telephone_number": "936-659-8278"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TH HEALTHCARE, LTD.",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-07",
"last_updated": "2022-03-24",
"certification_date": "2022-03-24",
"status": "A",
"authorized_official_last_name": "ABERCROMBIE",
"authorized_official_first_name": "ZACH",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "205-620-7095",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "TX",
"license": "000423",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHIP SUPERIOR HEALTH PLAN",
"identifier": "114113",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "133465808",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "000412",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF TEXAS",
"identifier": "HH0609",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA US HEALTHCARE",
"identifier": "077747670",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "133465809",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "133465802",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1734705",
"state": "LA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Shelby Regional Medical Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Shelby Regional Medical Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Center, TX
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- Texas Quick Care, LLC
- Jane D Todd, MD
- Kasi Trent Ashley, LPC-ASSOCIATE
- Vcphcs Xviii,LLC (Texas Treatment Center-Center)
- Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-0364)
- Lauren Kay Warr
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.