NPIMap

Organization Active NPI

Shamrock Community Hospital Inc

Doing business as Houston County Community Hospital

  • Critical Access Hospital
  • Erin, TN
National Provider Identifier
1811566540
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
SHAMROCK COMMUNITY HOSPITAL INC
Doing business as
Houston County Community Hospital
Practice address
5001 E Main St
Erin, TN 37061-4115
Phone
(731) 968-3646
NPI assigned
Jun 17, 2021
Last updated
Aug 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Authorized official

Name
Larry Henson
Title
RCD
Phone
(336) 944-6420

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

5001 E Main St
Erin, TN 37061-4115

Mailing address

5001 E Main St
Erin, TN 37061-4115
Phone (931) 289-4211

Other identifiers 1

IdentifierTypeStateIssuer
Q077262MedicaidTN

Other names 1

  • Houston County Community Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220927001035 TN Part A Provider - Critical Access Hospital 8325422082 Receives reassigned benefits from 37 practitioners
Practice locations: Erin, TN
O20230302002860 TN Part A Provider - Critical Access Hospital 8325422082 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Erin, TN

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1811566540. Details of each certification follow.

Hospital certification: CCN 441322

Legal name
SHAMROCK COMMUNITY HOSPITAL INC
Doing business as
HOUSTON COUNTY COMMUNITY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Apr 20, 2018
Last certification
Jul 3, 2013
Beds
25
Ownership / control type
Local
Organization structure
CorporationProprietary
Enrollment address
5001 E Main St
Erin, TN 37061-4115
Other Hospital Practice Location

Hospital certification: CCN 44Z322

Legal name
SHAMROCK COMMUNITY HOSPITAL INC
Doing business as
HOUSTON COUNTY COMMUNITY HOSPITAL
Organization structure
CorporationProprietary
Enrollment address
5001 E Main St
Erin, TN 37061-4115
Hospital Swing-Bed Unit

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

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Houston County Community HospitalCCN 441322 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

5001 E Main St
Erin, TN 37061
Phone (336) 944-6420

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Braden Health Inc Organization, Greensboro, NC Corporation, For-profit 5% Or Greater Direct Ownership Interest Aug 1, 2022 100%
Beau R Braden Individual 5% Or Greater Direct Ownership Interest Aug 1, 2022
Corporate Officer Aug 1, 2022
Corporate Director Aug 1, 2022
5% Or Greater Direct Ownership InterestCeo Braden Health Aug 1, 2022
William Lomax Individual W-2 Managing Employee Feb 1, 2023
W-2 Managing EmployeeAd; Feb 1, 2023
Brooks Braden Individual 5% Or Greater Direct Ownership Interest Aug 1, 2022
5% Or Greater Direct Ownership InterestCoo Braden Health Aug 1, 2022
Joseph Rivera Individual Corporate Director Aug 1, 2022
Corporate DirectorCto Aug 1, 2022
Larry Henson Individual Corporate Officer Aug 1, 2022
Corporate OfficerRCD, Authorized Official Aug 1, 2022
Richard D Matthews Individual Corporate Director Aug 1, 2022
Corporate DirectorCmo Aug 1, 2022
Kyle Kopec Individual Corporate Director Aug 1, 2022
Corporate DirectorCco Aug 1, 2022

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 10

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

Practitioners & affiliated clinicians

Practitioners 46

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 46

Affiliated clinicians 20

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722470400000",
    "number": "1811566540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 E MAIN ST",
            "city": "ERIN",
            "state": "TN",
            "postal_code": "370614115",
            "telephone_number": "931-289-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 E MAIN ST",
            "city": "ERIN",
            "state": "TN",
            "postal_code": "370614115",
            "telephone_number": "731-968-3646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAMROCK COMMUNITY HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-17",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A",
        "authorized_official_last_name": "HENSON",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "RCD",
        "authorized_official_telephone_number": "336-944-6420"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q077262",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Houston County Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Erin, TN

Sources for this page

Verify at the official NPI Registry.