NPIMap

Organization Active NPI

Arh Mary Breckinridge Health Services, Inc.

Doing business as ARH Cumberland Valley Medical and Surgical Associates- Barbourville

  • Rural Health Clinic/Center
  • Barbourville, KY
National Provider Identifier
1770029126
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ARH MARY BRECKINRIDGE HEALTH SERVICES, INC.
Doing business as
ARH Cumberland Valley Medical and Surgical Associates- Barbourville
Practice address
80 Hospital Dr Ste 2
Barbourville, KY 40906-7363
Phone
(606) 545-4460
Fax
(606) 545-4469
NPI assigned
Jan 10, 2017
Last updated
Sep 18, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
APPALACHIAN REGIONAL HEALTHCARE, INC.As reported in NPPES

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
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

80 Hospital Dr Ste 2
Barbourville, KY 40906-7363

Mailing address

80 Hospital Dr Ste 2
Barbourville, KY 40906-7363
Phone (606) 545-4460

Other names 1

  • ARH Cumberland Valley Medical and Surgical Associates- Barbourville 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, MD3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20170316001594 KY Part B Supplier - Clinic/Group Practice 8123293818 Receives reassigned benefits from 85 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Corbin, KY; Middlesboro, KY; Louisville, KY; Fort Thomas, KY; Barbourville, KY; Ashland, KY; Lexington, KY
O20170414000179 KY Part A Provider - Rural Health Clinic 8123293818 Practice locations: Barbourville, KY
O20231220000086 MD Part B Supplier - Clinic/Group Practice 8123293818 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dayton, MD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770029126. Details of each certification follow.

Rural health clinic certification: CCN 183497

Legal name
ARH MARY BRECKINRIDGE HEALTH SERVICES INC
Doing business as
ARH CUMBERLAND VALLEY MEDICAL
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 7, 2017
Last certification
Nov 18, 2019
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
May 31, 2011 in KY
Enrollment address
80 Hospital Dr
Ste 2
Barbourville, KY 40906-7363
Related CCNs
181328

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

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Part of
Arh Consolidated Lab

Member of 1

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

Locations

302 S Walnut St
Pineville, KY 40977
Phone (606) 302-2034

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
Hollie Harris Individual Corporate OfficerPresident and Ceo May 10, 2021
Appalachian Regional Healthcare Inc Organization, Lexington, KY Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest May 31, 2011 100%
Andrea Massey Individual Corporate DirectorBoard Member Nov 8, 2019
Christi Lee Individual Corporate OfficerChief Legal Officer Nov 28, 2023
Corporate DirectorChief Legal Officer Nov 28, 2023
Byron Lynn Gabbard Individual Corporate OfficerChief Financial Officer Nov 28, 2023
Corporate DirectorChief Financial Officer Nov 28, 2023
Susan Renae Neace Individual W-2 Managing EmployeeSys. Dir of Med. Aff and Enrollment May 31, 2011
Charles Lovell Individual W-2 Managing EmployeeCommunity Ceo Dec 1, 2015

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 30

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 30

NPI Registry JSON

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

{
    "created_epoch": "1484006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1770029126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 HOSPITAL DR STE 2",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409067363",
            "telephone_number": "606-545-4460",
            "fax_number": "606-545-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 HOSPITAL DR STE 2",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409067363",
            "telephone_number": "606-545-4460",
            "fax_number": "606-545-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARH MARY BRECKINRIDGE HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "APPALACHIAN REGIONAL HEALTHCARE, INC.",
        "enumeration_date": "2017-01-10",
        "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": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "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 Cumberland Valley Medical and Surgical Associates- Barbourville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ARH Cumberland Valley Medical and Surgical Associates- Barbourville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Barbourville, KY

Sources for this page

Verify at the official NPI Registry.