Organization Active NPI

NHC Healthcare-Moulton LLC

  • Skilled Nursing Facility
  • Moulton, AL
National Provider Identifier
1639104235
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
12597 Issued in AL
Legal business name
NHC HEALTHCARE-MOULTON LLC
Practice address
300 Hospital St
Moulton, AL 35650-1268
Phone
(256) 974-1146
NPI assigned
Jul 11, 2006
Last updated
Oct 25, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
NATIONAL HEALTHCARE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Authorized official

Name
D Doran Johnson
Title
Manager
Phone
(931) 424-1456

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 12597 AL Primary

Addresses

Primary practice location

300 Hospital St
Moulton, AL 35650-1268

Mailing address

300 Hospital St
Moulton, AL 35650-1268
Phone (256) 974-1146

Other identifiers 3

IdentifierTypeStateIssuer
4753340SMedicaidAL
3003340OtherTNBC BS
010-631OtherALBC BS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111202000696 AL Part A Provider - Skilled Nursing Facility 8820263882 Practice locations: Moulton, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639104235. Details of each certification follow.

Skilled nursing facility certification: CCN 015128

Legal name
NHC HEALTHCARE-MOULTON LLC
Doing business as
NHC HEALTHCARE, MOULTON
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 1, 1977
Last certification
Nov 6, 2019
Beds
136
Ownership / control type
Corporation
Multi-facility organization
NATIONAL HEALTHCARE
Organization structure
LLCProprietary
Incorporated
Oct 12, 1999 in AL
Enrollment address
300 Hospital Street
Moulton, AL 35650-1268
Nursing home name
NHC HEALTHCARE, MOULTON
Affiliated entity
NATIONAL HEALTHCARE CORPORATION

Care Compare: Nursing home

Medicare Care Compare
Listed as
NHC Healthcare, MoultonCCN 015128 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Sep 1, 1977
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
136111.4 residents per day on average
Chain
National Healthcare Corporation69 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Part of
National Healthcare Corporation

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Timothy Shelly Individual Operational/Managerial Control Jul 12, 2024
Robert M Ussery Individual Operational/Managerial Control Jan 1, 2009
Charles Bidwell Individual Corporate OfficerManager of LLC Jun 15, 2021
Operational/Managerial Control Jun 15, 2021
Managing Control - Governing BodyManager of LLC Jun 15, 2021
National Health Corporation Organization, Murfreesboro, TN Corporation, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2001 6.5%
Adp of the SNF Mar 31, 2025
Organization, Murfreesboro, TN Corporation, For-profit, Real estate investment trust (REIT) Adp of the SNF Jan 1, 2001
Blackrock Inc Organization, New York, NY Corporation, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 20, 2019 12.6%
Adp of the SNF Jan 20, 2010
Morgan Stanley Organization, New York, NY Corporation, Investment firm, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Nov 8, 2024 5.3%
Vanguard Group Inc Organization, Malvern, PA Investment firm, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 27, 2017 9%
Adp of the SNF Nov 30, 2006
Vicki L Dodson Individual Operational/Managerial Control Jun 1, 2019
Adp of the SNF Jun 1, 2019
Rex C Tuckier Individual Operational/Managerial Control Jun 6, 2017
Adp of the SNF Mar 31, 2025
Joshua B Hubbuch Individual Operational/Managerial Control May 6, 2024
Adp of the SNF Jul 3, 2025
Morgan Stanley Institutional Advisors LLC Organization, Greenwood Village, CO LLC, Owned by another organization or individual Indirect Ownership Interest Nov 8, 2024 4.8%
Luci Steien Individual Operational/Managerial Control Jul 16, 2007
NHC-Op LP Organization, Murfreesboro, TN For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 1, 2001 99%
Operational/Managerial Control Jan 1, 2001
National Healthcare Corporation Organization, Murfreesboro, TN Corporation, For-profit, Chain home office 5% Or Greater Indirect Ownership Interest Jan 1, 2001 98%
Operational/Managerial Control Jan 1, 2001
Adp of the SNF Mar 31, 2025
NHC/Delaware Inc Organization, Murfreesboro, TN Corporation, Owned by another organization or individual Direct Ownership Interest Jan 1, 2001 1%
Dimensional Fund Advisors LP Organization, Austin, TX Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 7, 2023 6%
Individual Adp of the SNF Jan 1, 2001
Brian Kidd Individual Operational/Managerial Control Jan 1, 2017
Adp of the SNF Jan 1, 2017

Owners & managing parties with NPI records 23

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

View all 23

Facilities with the same owner 100

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

View all 100

Practitioners & affiliated clinicians

Practitioners 2

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 1

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": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635120000000",
    "number": "1639104235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HOSPITAL ST",
            "city": "MOULTON",
            "state": "AL",
            "postal_code": "356501268",
            "telephone_number": "256-974-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HOSPITAL ST",
            "city": "MOULTON",
            "state": "AL",
            "postal_code": "356501268",
            "telephone_number": "256-974-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NHC HEALTHCARE-MOULTON LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NATIONAL HEALTHCARE CORPORATION",
        "enumeration_date": "2006-07-11",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "D",
        "authorized_official_middle_name": "DORAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "931-424-1456"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AL",
            "license": "12597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4753340S",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "3003340",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "010-631",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moulton, AL

Sources for this page

Verify at the official NPI Registry.