NPIMap

Organization Active NPI

Cullman Regional Medical Center, Inc.

  • Community Based Hospice Care Agency
  • Cullman, AL
National Provider Identifier
1699770792
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
10210 Issued in AL
Legal business name
CULLMAN REGIONAL MEDICAL CENTER, INC.
Practice address
1912 Alabama Hwy 157
Cullman, AL 35058
Phone
(256) 739-5185
Fax
(256) 737-0985
NPI assigned
Jun 15, 2005
Organization subpart
Yes
Parent organization
CULLMAN REGIONAL MEDICAL CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Authorized official

Name
Susan R Johnson, RN
Title
Director
Phone
(256) 739-5185

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 10210 AL Primary

Addresses

Primary practice location

1912 Alabama Hwy 157
Cullman, AL 35058

Mailing address

P.O. Box 1108
Cullman, AL 35056-1108
Phone (256) 739-5185

Other identifiers 1

IdentifierTypeStateIssuer
PIC0035EMedicaidAL

Other names 1

  • Hospice of Cullman County Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100719000638 AL Part A Provider - Hospice 3274445242 Practice locations: Cullman, AL

Hospice certification: CCN 011510

Legal name
CULLMAN REGIONAL MEDICAL CENTER INC
Doing business as
CULLMAN REGIONAL HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Feb 18, 1988
Last certification
Sep 2, 2021
Ownership / control type
Combination Government and Nonprofit
Organization structure
CorporationNon-profit
Incorporated
Nov 26, 2006 in AL
Enrollment address
1938 Al Highway 157
Ste 102
Cullman, AL 35058-1819

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Cullman Regional HospiceCCN 011510
Ownership
For-Profit
Certified
Feb 18, 1988
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Cullman Reg Medblount SP12 organizations share this tax ID, including this one
Part of
Cullman Reg Medblount SP

Other organizations with this tax ID 11

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.

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Erin D Britt Individual W-2 Managing EmployeeMedical Director Mar 1, 2024
Dana Martin Individual W-2 Managing EmployeeBusiness Manager of Home Care Jul 1, 2008 100%
Tonya Foster Individual W-2 Managing EmployeeDirector of Home Care and Hospice Mar 1, 2024
Charna Brown Individual W-2 Managing EmployeeVP of Nursing - Cullman Reg Med Ctr Mar 1, 2024
Nesha Donaldson Individual Corporate Officer Jan 22, 2019
Tia Sharp Individual W-2 Managing EmployeeHospice Clinical Manager Mar 1, 2024
Health Care Authority of Cullman Organization, Cullman, AL Corporation, Non-profit 5% Or Greater Direct Ownership Interest Nov 26, 2006 100%

Owners & managing parties with NPI records 2

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

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1118793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710460800000",
    "number": "1699770792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1108",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350561108",
            "telephone_number": "256-739-5185",
            "fax_number": "256-737-0985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 ALABAMA HWY 157",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "35058",
            "telephone_number": "256-739-5185",
            "fax_number": "256-737-0985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CULLMAN REGIONAL MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CULLMAN REGIONAL MEDICAL CENTER, INC.",
        "enumeration_date": "2005-06-15",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "256-739-5185",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "AL",
            "license": "10210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PIC0035E",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hospice of Cullman County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cullman, AL

Sources for this page

Verify at the official NPI Registry.