NPIMap

Organization Active NPI

D.W. McMillan Memorial Hospital

Doing business as D W McMillan Medical Center

  • Multi-Specialty Clinic/Center
  • Brewton, AL
National Provider Identifier
1679196927
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
D.W. MCMILLAN MEMORIAL HOSPITAL
Doing business as
D W McMillan Medical Center
Practice address
1121 Belleville Ave
Brewton, AL 36426-1500
Phone
(251) 867-6071
Fax
(251) 867-5999
NPI assigned
May 21, 2020
Last updated
May 3, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
D. W. MCMILLAN MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 3, 2024

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
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1121 Belleville Ave
Brewton, AL 36426-1500

Mailing address

1121 Belleville Ave
Brewton, AL 36426-1500
Phone (251) 867-6071

Other names 1

  • D W McMillan Medical Center Doing business as

Electronic endpoints 7

TypeEndpointUseAffiliation
Direct Messaging Address ataylor@echca.cernerdirect.com Direct
Direct Messaging Address DWMMEDCENTER@echa.cernerdirect.com Direct
Direct Messaging Address nyoung@echca.cernerdirect.com Direct
Direct Messaging Address MVILLARREAL@echca.cernerdirect.com Direct
Direct Messaging Address ELOW@echca.cernerdirect.com Direct
Direct Messaging Address ebataglia@echca.cernerdirect.com Direct
Direct Messaging Address JWALKER@echca.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20051228000313 AL Part B Supplier - Clinic/Group Practice 3072558378 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brewton, AL
O20200812003631 AL Part B Supplier - Clinic/Group Practice 3072558378 Receives reassigned benefits from 14 practitioners
Practice locations: Brewton, AL
O20210115001433 AL Part A Provider - Rural Health Clinic 3072558378 Practice locations: Brewton, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679196927. Details of each certification follow.

Rural health clinic certification: CCN 013498

Legal name
D.W. MCMILLAN MEMORIAL HOSPITAL
Doing business as
D W MCMILLAN MEDICAL CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 5, 2021
Last certification
Dec 4, 2024
Ownership / control type
1B
Organization structure
OtherNon-profit
Enrollment address
1121 Belleville Ave
Brewton, AL 36426-1500
Related CCNs
010099

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).

Other NPIs on the same Medicare enrollment 1

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

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
01D0305072D W McMillan Medical Center1121 Belleville Avenue, Brewton, AL 36426AccreditationDec 22, 2027

National Provider Directory

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

Other organizations with this tax ID 5

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

Member of 1

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

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

1674 Cleveland Ave
Castleberry, AL 36432
Phone (251) 966-3400

636 Jackson St
Flomaton, AL 36441
Phone (251) 296-2456

Interoperability endpoints

  • Direct secure messaging: ataylor@echca.cernerdirect.com
  • Direct secure messaging: dwmmedcenter@echa.cernerdirect.com
  • Direct secure messaging: ebataglia@echca.cernerdirect.com
  • Direct secure messaging: jwalker@echca.cernerdirect.com
  • Direct secure messaging: mvillarreal@echca.cernerdirect.com
  • Direct secure messaging: nyoung@echca.cernerdirect.com

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Lori Britt Individual W-2 Managing EmployeeClinic Manager Aug 1, 2020
Susan S Hines Individual Operational/Managerial ControlAdministrator Jan 1, 2022
James J Walker Individual W-2 Managing EmployeeMedical Doctor Aug 1, 2020
D.W. McMillan Memorial Hospital Organization, Brewton, AL Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2005 100%
Stephen Fischer Individual Corporate Officer Jan 1, 2020

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 1

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

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 46

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 46

NPI Registry JSON

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

{
    "created_epoch": "1590019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714694400000",
    "number": "1679196927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 BELLEVILLE AVE",
            "city": "BREWTON",
            "state": "AL",
            "postal_code": "364261500",
            "telephone_number": "251-867-6071",
            "fax_number": "251-867-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 BELLEVILLE AVE",
            "city": "BREWTON",
            "state": "AL",
            "postal_code": "364261500",
            "telephone_number": "251-867-6071",
            "fax_number": "251-867-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D.W. MCMILLAN MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "D. W. MCMILLAN MEMORIAL HOSPITAL",
        "enumeration_date": "2020-05-21",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "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": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ataylor@echca.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "D W McMillan Medical Center Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1121 Belleville Ave",
            "city": "Brewton",
            "state": "AL",
            "country_code": "US",
            "postal_code": "364261500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DWMMEDCENTER@echa.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "DWM Medical Center Direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1121 Belleville Ave",
            "city": "Brewton",
            "state": "AL",
            "country_code": "US",
            "postal_code": "364261500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nyoung@echca.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "D W McMillan Medical Center Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1121 Belleville Ave",
            "city": "Brewton",
            "state": "AL",
            "country_code": "US",
            "postal_code": "364261500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MVILLARREAL@echca.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "D W McMillan Medical Center Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1121 Belleville Ave",
            "city": "Brewton",
            "state": "AL",
            "country_code": "US",
            "postal_code": "364261500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ELOW@echca.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "D W McMillan Medical Center Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1121 Belleville Ave",
            "city": "Brewton",
            "state": "AL",
            "country_code": "US",
            "postal_code": "364261500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ebataglia@echca.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "D W McMillan Medical Center Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1121 Belleville Ave",
            "city": "Brewton",
            "state": "AL",
            "country_code": "US",
            "postal_code": "364261500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JWALKER@echca.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "D W McMillan Medical Center Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1121 Belleville Ave",
            "city": "Brewton",
            "state": "AL",
            "country_code": "US",
            "postal_code": "364261500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "D W McMillan Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "D W McMillan Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brewton, AL

Sources for this page

Verify at the official NPI Registry.