NPIMap

Organization Active NPI

John Ed Chambers Memorial Hospital, Inc.

  • Rural Acute Care Hospital
  • Danville, AR
National Provider Identifier
1902842255
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
License
AR4293 Issued in AR
Legal business name
JOHN ED CHAMBERS MEMORIAL HOSPITAL, INC.
Practice address
719 Detroit Ave
Danville, AR 72833-9607
Phone
(479) 495-2241
Fax
(479) 495-6290
NPI assigned
Jun 22, 2006
Last updated
Sep 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Authorized official

Name
Michael Scott Peek
Title
Ceo
Phone
(479) 495-2241

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X NU
Rural Acute Care Hospital 282NR1301X AR4293 AR Primary

Addresses

Primary practice location

719 Detroit Ave
Danville, AR 72833-9607

Mailing address

PO Box 639
Danville, AR 72833-0639
Phone (479) 495-2241

Other identifiers 2

IdentifierTypeStateIssuer
106600105MedicaidAR
10011OtherARBLUE CROSS PROVIDER NUMBE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ehr-direct@jecmh.hin.us Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070313000287 AR Part A Provider - Hospital 4688628167 4 other NPIs on this enrollment
Practice locations: Danville, AR; Plainview, AR; Havana, AR; Ola, AR
O20180404000061 AR Part A Provider - Hospital 4688628167 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Danville, AR

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1902842255. Details of each certification follow.

Hospital certification: CCN 040011

Legal name
JOHN ED CHAMBERS MEMORIAL HOSPITAL INC
Doing business as
CHAMBERS MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jul 30, 2021
Beds
42
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Oct 29, 1997 in AR
Enrollment address
719 Detroit Avenue
Danville, AR 72833-0639
Main/Primary Hospital Location
Hospital subgroups
Acute care

Hospital certification: CCN 04S011

Legal name
JOHN ED CHAMBERS MEMORIAL HOSPITAL INC
Organization structure
CorporationNon-profit
Incorporated
Oct 29, 1997 in AR
Enrollment address
719 Detroit Ave
Danville, AR 72833-9607
Other Hospital Practice Location
Hospital subgroups
Psychiatric

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

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 5

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Chambers Memorial HospitalCCN 040011 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: ehr-direct@jecmh.hin.us

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
John Chambers Individual Corporate Director Mar 12, 1984
Michael Peek Individual Corporate OfficerCeo Jun 1, 2021 100%
W-2 Managing EmployeeCeo Jun 1, 2021 100%
Operational/Managerial ControlCeo Jun 1, 2021 100%
Corporate OfficerCeo Jul 1, 2021 100%
W-2 Managing EmployeeCeo Jul 1, 2021 100%
Operational/Managerial ControlCeo Jul 1, 2021 100%
Tommy D Papasan Individual Corporate DirectorBoard of Directors Jul 16, 2014
John Ed Chambers Memorial Hospital Inc Organization, Danville, AR Corporation, Non-profit Operational/Managerial Control Jun 1, 2021 100%
Philip Alexander Individual Corporate Director Aug 18, 2004
Paul Sanders Individual Corporate Director Jul 1, 1995
Kayla Walker Individual W-2 Managing EmployeeBusiness Office Jun 1, 2021 1%
Operational/Managerial ControlBusiness Office Jun 1, 2021 1%
Paula M Cornwell Individual Corporate OfficerCfo Jan 1, 2021
W-2 Managing EmployeeCfo Jun 1, 2021 1%
Operational/Managerial ControlCfo Jun 1, 2021 1%
W-2 Managing EmployeeBusiness Office Manager May 23, 2016
David Fisher Individual Corporate Director Jul 9, 1984
Ritchie Tippin Individual Corporate Director Jul 14, 1986

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Chambers Memorial HospitalDanville, AR, CCN 04U011 Hospital Operational/Managerial Control (100%) Jun 1, 2021
Chambers Memorial Hospital Home HealthDanville, AR, CCN 047096 Home health agency Operational/Managerial Control (100%) Jun 1, 2021

Owned or controlled facilities with NPI records 6

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

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Affiliated clinicians 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631750400000",
    "number": "1902842255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639",
            "city": "DANVILLE",
            "state": "AR",
            "postal_code": "728330639",
            "telephone_number": "479-495-2241",
            "fax_number": "479-495-6290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 DETROIT AVE",
            "city": "DANVILLE",
            "state": "AR",
            "postal_code": "728339607",
            "telephone_number": "479-495-2241",
            "fax_number": "479-495-6290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN ED CHAMBERS MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A",
        "authorized_official_last_name": "PEEK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "479-495-2241"
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "AR",
            "license": "AR4293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106600105",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMBE",
            "identifier": "10011",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ehr-direct@jecmh.hin.us",
            "affiliation": "N",
            "endpointDescription": "Chambers Memorial Hospital Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "719 Detroit Ave",
            "city": "Danville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "728339607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Danville, AR

Sources for this page

Verify at the official NPI Registry.