NPIMap

Organization Active NPI

Cameron Memorial Community Hospital Inc

Doing business as Cameron Family Medicine

  • Rural Health Clinic/Center
  • Angola, IN
National Provider Identifier
1730357245
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
01033506A Issued in IN
Legal business name
CAMERON MEMORIAL COMMUNITY HOSPITAL INC
Doing business as
Cameron Family Medicine
Practice address
1500 W Maumee St
Angola, IN 46703-8605
Phone
(260) 665-8494
NPI assigned
Feb 19, 2008
Last updated
Jul 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Authorized official

Name
Angela Logan
Title
Ceo
Phone
(260) 667-5133

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 01033506A IN Primary

Addresses

Primary practice location

1500 W Maumee St
Angola, IN 46703-8605

Mailing address

1500 W Maumee St
Angola, IN 46703-8605
Phone (260) 665-8494

Other identifiers 2

IdentifierTypeStateIssuer
100225670MedicaidIN
200185720AMedicaidIN

Other names 1

  • CAMERON FAMILY MEDICINE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040323001008 IN Part B Supplier - Clinic/Group Practice 9234020835 Receives reassigned benefits from 136 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Angola, IN; Fremont, IN; Fort Wayne, IN
O20170927002980 IN Part A Provider - Rural Health Clinic 9234020835 Practice locations: Angola, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730357245. Details of each certification follow.

Rural health clinic certification: CCN 158530

Legal name
CAMERON MEMORIAL COMMUNITY HOSPITAL INC
Doing business as
CAMERON FAMILY MEDICINE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 31, 2016
Last certification
Aug 14, 2019
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1972 in IN
Enrollment address
1500 W Maumee St
Angola, IN 46703-8605
Related CCNs
151315

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

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 6

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
15D0357522Cameron Family Medicine1500 West Maumee St, Angola, IN 46703Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Todd C Rumsey Individual Corporate OfficerTreasurer Sep 30, 2013
Ann Rice Individual Corporate Officer Apr 25, 2023
Wendy Jean Stamper Individual Corporate DirectorController Feb 1, 2020
Jonathan Orlando Cress Individual Corporate Officer Apr 25, 2023
Michael Connell Individual Corporate Officer Apr 25, 2023
Deborah E McHenry Individual Corporate OfficerChair Sep 30, 2013
Lynn V Faur Individual Corporate Officer Apr 25, 2023
Scott Gruner Individual Corporate Officer Dec 11, 2023
Janelle Sponsler Individual W-2 Managing EmployeeDirector of PT Accting May 1, 2021
Angela M Logan Individual Corporate OfficerCeo May 1, 2021
Jeffrey R Nickel Individual Corporate Officer Apr 25, 2023
Andrew Michael Aldred Individual Corporate OfficerCoo Feb 2, 2020
Donna K Elbrecht Individual Corporate Officer Apr 25, 2023
John McCoy Individual Corporate OfficerVice Chair Sep 30, 2013

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Cameron Memorial Community Hospital IncAngola, IN, CCN 15Z315 Hospital Operational/Managerial Control Jan 1, 1989
Cameron Jointaccess Ortho & UrgentAngola, IN, CCN 158545 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 25, 2023
Cameron OB/GYNAngola, IN, CCN 158546 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 25, 2023
Cameron Family Medicine - NorthAngola, IN, CCN 158570 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2021
Cameron Family Medicine FremontFremont, IN, CCN 158571 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2023

Owned or controlled facilities with NPI records 6

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

NPI Registry JSON

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751846400000",
    "number": "1730357245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 W MAUMEE ST",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467038605",
            "telephone_number": "260-665-8494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W MAUMEE ST",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467038605",
            "telephone_number": "260-665-8494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMERON MEMORIAL COMMUNITY HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "260-667-5133"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "IN",
            "license": "01033506A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100225670",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200185720A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAMERON FAMILY MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CAMERON FAMILY MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Angola, IN

Sources for this page

Verify at the official NPI Registry.