NPIMap

Organization Active NPI

Ohio County Hospital Corporation

  • Rural Health Clinic/Center
  • Fordsville, KY
National Provider Identifier
1750447231
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
900048 Issued in KY
Legal business name
OHIO COUNTY HOSPITAL CORPORATION
Practice address
44 W Main St
Fordsville, KY 42343-9761
Phone
(270) 276-9953
Fax
(270) 276-9958
NPI assigned
Dec 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Authorized official

Name
Jennifer Daugherty
Title
PFS Director
Phone
(270) 504-1910

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 900048 KY Primary

Addresses

Primary practice location

44 W Main St
Fordsville, KY 42343-9761

Mailing address

44 W Main St
Fordsville, KY 42343-9761
Phone (270) 276-9953

Other identifiers 1

IdentifierTypeStateIssuer
35000454MedicaidKY

Other names 1

  • FORDSVILLE AREA MEDICAL CLINIC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120406000447 KY Part A Provider - Rural Health Clinic 3577477264 Practice locations: Fordsville, KY

Rural health clinic certification: CCN 183408

Legal name
OHIO COUNTY HOSPITAL CORPORATION
Doing business as
FORDSVILLE AREA MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 6, 1995
Last certification
Jan 21, 2015
Ownership / control type
2A
Organization structure
CorporationNon-profit
Incorporated
Feb 3, 1984 in KY
Enrollment address
44 W Main St
Fordsville, KY 42343-9761
Related CCNs
181323

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

Other NPIs with the same Medicare PAC ID 9

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

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
18D0897959Fordsville Area Medical Clinic44 West Main Street, Fordsville, KY 42343Certificate of waiverFeb 20, 2027

National Provider Directory

National Provider Directory
Tax ID family
Fordsville Medical Clin32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

Member organizations 1

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

Locations

44 W Main St
Fordsville, KY 42343
Phone (270) 276-3150

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Lloyd Spivey Individual Corporate DirectorBoard Member Jan 1, 2014
Suzette Temple Individual Corporate DirectorBoard Member Feb 18, 2021
Ovation Health Organization, Brentwood, TN Management services company Operational/Managerial Control Mar 1, 1984
Elizabeth Lunsford Individual Corporate DirectorBoard Member Sep 14, 2020
James Duke Individual Corporate DirectorBoard Member Jan 1, 2018
Kelly Roe Individual Corporate DirectorBoard Member Jan 1, 2003
Jonathan Shrewsbury Individual Corporate DirectorBoard Member-President Jan 1, 1994
Nicole Marie Akers Individual Corporate Director Jan 1, 2023
Stuart Hibbs Individual W-2 Managing EmployeeCfo Jan 1, 2023
Eddie L Embry Individual Corporate DirectorBoard Member Oct 12, 2020
Shellie Shouse Individual Corporate OfficerCeo Jan 1, 2018
Carla Wallace Individual Corporate DirectorBoard Member Jan 1, 2005

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 1

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

FacilityTypeRoleSince
Butler County Family CareMorgantown, KY, CCN 183489 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 3, 1984

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 18

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

View all 18

Practitioners & affiliated clinicians

Practitioners 84

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

View all 84

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1750447231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 W MAIN ST",
            "city": "FORDSVILLE",
            "state": "KY",
            "postal_code": "423439761",
            "telephone_number": "270-276-9953",
            "fax_number": "270-276-9958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 W MAIN ST",
            "city": "FORDSVILLE",
            "state": "KY",
            "postal_code": "423439761",
            "telephone_number": "270-276-9953",
            "fax_number": "270-276-9958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO COUNTY HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "DAUGHERTY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PFS DIRECTOR",
        "authorized_official_telephone_number": "270-504-1910"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "KY",
            "license": "900048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35000454",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FORDSVILLE AREA MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FORDSVILLE AREA MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fordsville, KY

Sources for this page

Verify at the official NPI Registry.