NPIMap

Organization Active NPI

Tanner Medical Center Alabama Inc

Doing business as Tanner Medical Center East Alabama

  • Critical Access Hospital
  • Wedowee, AL
National Provider Identifier
1912428301
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
TANNER MEDICAL CENTER ALABAMA INC
Doing business as
Tanner Medical Center East Alabama
Practice address
1032 Main St South
Wedowee, AL 36278-5139
Phone
(256) 357-2111
NPI assigned
Jul 6, 2017
Last updated
Oct 3, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Authorized official

Name
Carol Crews
Title
Cfo
Phone
(770) 812-9745

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

1032 Main St South
Wedowee, AL 36278-5139

Mailing address

705 Dixie St
Carrollton, GA 30117-3818

Other names 2

  • Tanner Medical Center East Alabama Doing business as
  • Tanner Medical Center Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190218002014 AL Part A Provider - Hospital 6507123726 Practice locations: Wedowee, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912428301. Details of each certification follow.

Hospital certification: CCN 011306

Legal name
TANNER MEDICAL CENTER ALABAMA INC
Doing business as
TANNER MEDICAL CENTER- EAST ALABAMA
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jan 9, 2019
Last certification
Aug 22, 2024
Beds
15
Ownership / control type
Hospital district or authority
Organization structure
CorporationNon-profit
Incorporated
Sep 10, 2015 in AL
Enrollment address
1032 Main St S
Wedowee, AL 36278-7440
Hospital Swing-Bed Unit
Hospital subgroups
General, Acute care, Swing-bed approved, Other

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).

Care Compare: Hospital

Medicare Care Compare
Listed as
Tanner Medical Center-East AlabamaCCN 011306 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member organizations 4

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

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
Daniel Gordon Jackson Individual Corporate DirectorBoard of Directors Nov 14, 2017
Jo Kicker Individual Corporate DirectorBoard of Directors Nov 14, 2017
Carol Crews Individual 5% Or Greater Indirect Ownership InterestCfo Nov 14, 2017 5%
Corporate DirectorCfo Sep 7, 2017
W-2 Managing EmployeeCfo Nov 14, 2017
Loy Howard Individual Corporate DirectorBoard of Directors Nov 14, 2017
Robert Bugg Individual Corporate DirectorBoard of Directors Sep 7, 2017
Ramona Diamond Individual Corporate DirectorBoard of Directors Sep 1, 2019
Carol Knight Individual Corporate DirectorBoard of Directors Dec 1, 2022
Jeff L Stewart Individual Corporate DirectorBoard of Directors Sep 7, 2017

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Tanner Primary Care of Roanoke IncRoanoke, AL, CCN 013484 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 18, 2019
Tanner Primary Care of WedoweeWedowee, AL, CCN 013480 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 30, 2019
Woodland Family HealthcareWoodland, AL, CCN 013481 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 30, 2019

Owned or controlled facilities with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 4

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.

Affiliated clinicians 115

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

View all 115

NPI Registry JSON

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

{
    "created_epoch": "1499299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570060800000",
    "number": "1912428301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 DIXIE ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 MAIN ST SOUTH",
            "city": "WEDOWEE",
            "state": "AL",
            "postal_code": "362785139",
            "telephone_number": "256-357-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANNER MEDICAL CENTER ALABAMA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-06",
        "last_updated": "2019-10-03",
        "status": "A",
        "authorized_official_last_name": "CREWS",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "770-812-9745"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tanner Medical Center East Alabama",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tanner Medical Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Tanner Medical Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wedowee, AL

Sources for this page

Verify at the official NPI Registry.