NPIMap

Organization Active NPI

Appalachian Regional Healthcare, Inc

Doing business as ARH Daniel Boone Clinic - Harlan

  • Rural Health Clinic/Center
  • Harlan, KY
National Provider Identifier
1669506523
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
APPALACHIAN REGIONAL HEALTHCARE, INC
Doing business as
ARH Daniel Boone Clinic - Harlan
Practice address
37 Ball Park Road
Harlan, KY 40831
Phone
(606) 573-4520
Fax
(606) 573-6392
NPI assigned
Mar 15, 2007
Last updated
Sep 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Authorized official

Name
Mrs. Hollie Harris
Title
President and Ceo
Phone
(859) 226-2511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

37 Ball Park Road
Harlan, KY 40831

Mailing address

37 Ball Park Road
Harlan, KY 40831
Phone (606) 573-4520

Other identifiers 1

IdentifierTypeStateIssuer
7100464330MedicaidKY

Other names 1

  • ARH Daniel Boone Clinic - Harlan Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, NC, OH4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20031125000520 KY Part B Supplier - Clinic/Group Practice 0840107835 Receives reassigned benefits from 432 practitioners
48 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20170727003329 KY Part A Provider - Rural Health Clinic 0840107835 Practice locations: Harlan, KY
O20220124002662 NC Part B Supplier - Clinic/Group Practice 0840107835 Receives reassigned benefits from 5 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mills River, NC; Mooresville, NC; Weaverville, NC; Weddington, NC; Davidson, NC
O20220820000109 OH Part B Supplier - Clinic/Group Practice 0840107835 Receives reassigned benefits from 19 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Minford, OH; Olmsted TWP, OH; Peninsula, OH; South Point, OH; Sugarcrk TWP, OH; Wheelersburg, OH; Wintersville, OH; Lucasville, OH…

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669506523. Details of each certification follow.

Rural health clinic certification: CCN 188508

Legal name
APPALACHIAN REGIONAL HEALTHCARE INC
Doing business as
ARH MEDICAL ASSOCIATES DBC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 1, 2017
Last certification
Aug 23, 2018
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jun 28, 1963 in KY
Enrollment address
37 Ball Park Rd
Harlan, KY 40831-1701
Related CCNs
180050

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

Other NPIs on the same Medicare enrollment 38

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

View all 38

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D0323850Arh Medical Associates37 Ball Park Road, Harlan, KY 40831Certificate of waiverMar 23, 2028

National Provider Directory

National Provider Directory

Locations

37 Ball Park Rd
Harlan, KY 40831
Phone (606) 263-3900

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Gregory a Wilson Individual Corporate DirectorBoard Member Nov 8, 2019
Hollie Harris Individual Corporate OfficerCeo and President May 10, 2021
Gregory Couch Individual Corporate DirectorDirector Nov 8, 2013
Maria Benoit Braman Individual Corporate OfficerVice President of Medical Affairs Mar 7, 2016
Andrea Massey Individual Corporate DirectorDirector Nov 4, 2016
Julie Rose Individual Corporate DirectorDirector Nov 5, 2014
Christi Lee Individual Corporate OfficerChief Legal Officer Nov 5, 2021
Joann Anderson Individual Corporate DirectorBoard Member Nov 2, 2017
Gregory Pauley Individual Corporate DirectorDirector Nov 5, 2010
Dustin S Campbell Individual Corporate DirectorBoard Member Nov 11, 2022
Samuel Dunn Individual Corporate DirectorBoard Member Dec 7, 1966
Jeffrey Hollon Individual Corporate DirectorDirector Nov 2, 2012
Larry B Francis Individual Corporate DirectorBoard Member Nov 2, 2017
Onzie Sizemore Individual Corporate DirectorDirector Nov 5, 2014
Karen Newman Individual Corporate DirectorBoard Member Nov 11, 2022
Theodore T Myre Individual Corporate DirectorBoard Member Nov 2, 2017
Susan Renae Neace Individual W-2 Managing EmployeeSys. Dir of Med. Aff and Enrollment Jan 3, 2005
Michael Rust Individual Corporate DirectorBoard Member Nov 18, 2019
Edith Kelly Individual Corporate DirectorBoard Member Nov 11, 2022
Ken Allman Individual Corporate DirectorBoard Member Nov 18, 2019

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 24

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

FacilityTypeRoleSince
Harlan Arh HospitalHarlan, KY, CCN 18S050 Hospital 5% Or Greater Direct Ownership Interest
Other		 Jan 1, 1966
Jan 1, 1966
Mary Breckinridge Arh HospitalHyden, KY, CCN 181316 Hospital Operational/Managerial Control (100%) Sep 7, 2011
Barbourville Arh HospitalBarbourville, KY, CCN 18Z328 Hospital 5% Or Greater Direct Ownership Interest (100%) May 31, 2011
Barbourville Arh HospitalBarbourville, KY, CCN 181328 Hospital 5% Or Greater Direct Ownership Interest (100%) May 31, 2011
Arh Our Lady of the WayMartin, KY, CCN 18Z305 Hospital 5% Or Greater Direct Ownership Interest (100%) May 31, 2011
Arh Our Lady of the WayMartin, KY, CCN 181305 Hospital 5% Or Greater Direct Ownership Interest (100%) May 31, 2011
Highlands Arh Regional Medical CenterPrestonsburg, KY, CCN 180005 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 19, 2013
Highlands Arh Regional Medical CenterPrestonsburg, KY, CCN 18S005 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 19, 2013
Paintsville Arh HospitalPaintsville, KY, CCN 180078 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 19, 2013
Arh Advanced Care - Big SandySouth Williamson, KY, CCN 182010 Hospital 5% Or Greater Direct Ownership Interest (100%) May 5, 2021
Arh Advance Care-Ky RiverHazard, KY, CCN 182011 Hospital 5% Or Greater Direct Ownership Interest (100%) May 5, 2021
Mary Breckinridge Arh HospitalHyden, KY, CCN 18Z316 Hospital Operational/Managerial Control Sep 7, 2011
Appalachian Regional Healthcare IncHarlan, KY, CCN 187025 Home health agency 5% Or Greater Indirect Ownership Interest Sep 10, 2008
Mary Breckinridge Arh Home Health AgencyHyden, KY, CCN 187001 Home health agency 5% Or Greater Direct Ownership Interest (100%) May 31, 2011
Highlands Arh Home Health AgencyPrestonsburg, KY, CCN 187169 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jul 19, 2013
Hyden Arh ClinicHyden, KY, CCN 183472 Rural health clinic Operational/Managerial Control (100%) Sep 7, 2011
Arh Cumberland Valley MedicalBarbourville, KY, CCN 183497 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) May 31, 2011
Arh Cumberland Valley Medical and Surgical AssociatesMiddlesboro, KY, CCN 188519 Rural health clinic Operational/Managerial Control (100%) May 31, 2011
Arh Women's and Family Health Center - MiddlesboroMiddlesboro, KY, CCN 188520 Rural health clinic Operational/Managerial Control (100%) Jun 8, 2018
Arh Primary Care Associates - NJMartin, KY, CCN 183442 Rural health clinic Operational/Managerial Control (100%) May 31, 2011
Arh Primary Care Associates - NiMartin, KY, CCN 183440 Rural health clinic Operational/Managerial Control (100%) May 31, 2011
Arh Cumberland Valley Medical and Specialty AssociatesMiddlesboro, KY, CCN 188540 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) May 31, 2011
Arh Medical and Specialty Associates-HighlandsPrestonsburg, KY, CCN 188553 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 19, 2013
Paintsville Arh Medical and Specialty AssociatesPaintsville, KY, CCN 188563 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) May 1, 2023

Practitioners & affiliated clinicians

Practitioners 26

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.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726790400000",
    "number": "1669506523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 BALL PARK ROAD",
            "city": "HARLAN",
            "state": "KY",
            "postal_code": "40831",
            "telephone_number": "606-573-4520",
            "fax_number": "606-573-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 BALL PARK ROAD",
            "city": "HARLAN",
            "state": "KY",
            "postal_code": "40831",
            "telephone_number": "606-573-4520",
            "fax_number": "606-573-6392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPALACHIAN REGIONAL HEALTHCARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "HOLLIE",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "859-226-2511",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100464330",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ARH Daniel Boone Clinic - Harlan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harlan, KY

Sources for this page

Verify at the official NPI Registry.