Organization Active NPI

Campbell County Hma, LLC

Doing business as Tennova Healthcare-LaFollette Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • La Follette, TN
National Provider Identifier
1831171693
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
0000000008 Issued in TN
Legal business name
CAMPBELL COUNTY HMA, LLC
Doing business as
Tennova Healthcare-LaFollette Medical Center
Practice address
923 E Central Ave
Lafollette, TN 37766-2055
Phone
(423) 907-1200
Fax
(423) 907-1189
NPI assigned
Nov 17, 2005
Last updated
Mar 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Authorized official

Name
Paula M Lalor
Title
Director/Delegated Official
Phone
(629) 215-3953

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 0000000008 TN Primary

Addresses

Primary practice location

923 E Central Ave
Lafollette, TN 37766-2055

Mailing address

923 E Central Ave
Lafollette, TN 37766-2055
Phone (423) 907-1200

Other identifiers 1

IdentifierTypeStateIssuer
044U033MedicaidTN

Other names 1

  • Tennova Healthcare-LaFollette Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111121000366 TN Part A Provider - Hospital 3173795168 Practice locations: Lafollette, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831171693. Details of each certification follow.

Hospital certification: CCN 44U033

Legal name
CAMPBELL COUNTY HMA LLC
Doing business as
TENNOVA HEALTHCARE-LAFOLLETTE MEDICAL CENTER
Organization structure
LLCProprietary
Incorporated
Jun 10, 2011 in TN
Enrollment address
923 East Central Avenue
Lafollette, TN 37766-2055
Hospital Swing-Bed Unit
Hospital subgroups
Swing-bed approved

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

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
Campbell County Hma LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the 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
Ronald Cain Individual W-2 Managing Employee Jan 27, 2014
Nathaniel K Summar Individual Corporate DirectorVP Revenue Management Jul 14, 2017
Justin D Pitt Individual Corporate OfficerPresident/Assistant Secretary Jan 6, 2026
Corporate DirectorPresident/Assistant Secretary Jan 6, 2026
Health Management Associates LLC Organization, Franklin, TN LLC 5% Or Greater Direct Ownership Interest Dec 31, 2016 100%
William Bradley Cash Individual Corporate OfficerExecutive Vice President Jun 1, 2018
Corporate DirectorExecutive Vice President Jan 6, 2026
Hma-Tri Holdings LLC Organization, Franklin, TN LLC 5% Or Greater Indirect Ownership Interest Jan 1, 2016 100%
Phillip a Posey Individual Corporate OfficerSenior Vice President Jan 6, 2026
Community Health Systems Inc Organization, Franklin, TN Corporation 5% Or Greater Indirect Ownership Interest Jan 27, 2014 100%
Jason Kevin Johnson Individual Corporate OfficerExecutive Vice President Jan 6, 2020
Corporate DirectorExecutive Vice President Jan 6, 2026
Roman Gabriel Ottinger Individual Corporate OfficerSenior VP/Treasurer Jan 6, 2020
Paula M Lalor Individual Corporate DirectorDelegated Official Apr 1, 2017
Edna S Buffington-Price Individual Corporate DirectorVP/Authorized Official Mar 1, 2022
Christopher G Cobb Individual Corporate OfficerVP/Secretary Apr 1, 2017
CHS Community Health Systems Inc Organization, Franklin, TN Corporation 5% Or Greater Indirect Ownership Interest Jan 27, 2014 100%

Facilities with the same owner 120

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

View all 120

NPI Registry JSON

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616976000000",
    "number": "1831171693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 E CENTRAL AVE",
            "city": "LAFOLLETTE",
            "state": "TN",
            "postal_code": "377662055",
            "telephone_number": "423-907-1200",
            "fax_number": "423-907-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 E CENTRAL AVE",
            "city": "LAFOLLETTE",
            "state": "TN",
            "postal_code": "377662055",
            "telephone_number": "423-907-1200",
            "fax_number": "423-907-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMPBELL COUNTY HMA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-17",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A",
        "authorized_official_last_name": "LALOR",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR/DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "629-215-3953"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "TN",
            "license": "0000000008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044U033",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tennova Healthcare-LaFollette Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tennova Healthcare-LaFollette Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Follette, TN

Sources for this page

Verify at the official NPI Registry.