NPIMap

Organization Active NPI

Arh Mary Breckinridge Health Services, Inc.

Doing business as ARH Our Lady of the Way

  • Medicare Defined Swing Bed Hospital Unit
  • Martin, KY
National Provider Identifier
1710470828
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
ARH MARY BRECKINRIDGE HEALTH SERVICES, INC.
Doing business as
ARH Our Lady of the Way
Practice address
11203 Main St
Martin, KY 41649-7999
Phone
(606) 285-6400
NPI assigned
Jun 13, 2018
Last updated
Sep 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X NU Primary

Addresses

Primary practice location

11203 Main St
Martin, KY 41649-7999

Mailing address

100 Airport Gardens Rd
Hazard, KY 41701-9529
Phone (606) 487-7524

Other names 1

  • ARH Our Lady of the Way 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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180815001331 KY Part A Provider - Critical Access Hospital 8123293818 Practice locations: Martin, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1710470828. Details of each certification follow.

Hospital certification: CCN 18Z305

Legal name
ARH MARY BRECKINRIDGE HEALTH SERVICES INC
Doing business as
ARH OUR LADY OF THE WAY
Organization structure
CorporationNon-profit
Incorporated
May 31, 2011 in KY
Enrollment address
11203 Main St
Martin, KY 41649-7999
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 18

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

View all 18

National Provider Directory

National Provider Directory
Tax ID family
Arh Mary Breckinridge HLTH13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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 5

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

NameRoleSinceShare
Hollie Harris Individual Corporate OfficerPresident & Ceo May 10, 2021
Appalachian Regional Healthcare Inc Organization, Lexington, KY Non-profit 5% Or Greater Direct Ownership Interest May 31, 2011 100%
Andrea Massey Individual Corporate DirectorBoard Member Nov 8, 2019
Danny Harris Individual Corporate OfficerVice President of Fiscal Affairs May 10, 2013
Corporate DirectorDirector May 10, 2013
Susan Renae Neace Individual W-2 Managing EmployeeSys Director of Medical Affairs Jan 3, 2005

Facilities with the same owner 22

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

View all 22

Practitioners & affiliated clinicians

Practitioners 6

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 7

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": "1528848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1710470828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 AIRPORT GARDENS RD",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019529",
            "telephone_number": "606-487-7524",
            "fax_number": "606-439-6927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11203 MAIN ST",
            "city": "MARTIN",
            "state": "KY",
            "postal_code": "416497999",
            "telephone_number": "606-285-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARH MARY BRECKINRIDGE HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-13",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "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": "Ms."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Our Lady of the Way",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ARH Our Lady of the Way",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Martin, KY

Sources for this page

Verify at the official NPI Registry.