NPIMap

Organization Active NPI

Cameron Memorial Community Hospital, Inc

Doing business as Cameron Family Medicine-North

  • Rural Health Clinic/Center
  • Angola, IN
National Provider Identifier
1922671809
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CAMERON MEMORIAL COMMUNITY HOSPITAL, INC
Doing business as
Cameron Family Medicine-North
Practice address
3250 Intertech Dr Ste a
Angola, IN 46703-7224
Phone
(260) 665-2646
Fax
(260) 665-8707
NPI assigned
Jul 20, 2021
Last updated
Jul 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Authorized official

Name
Angela Logan
Title
Ceo
Phone
(260) 667-5330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

3250 Intertech Dr Ste a
Angola, IN 46703-7224

Mailing address

416 E Maumee St
Angola, IN 46703-2015
Phone (260) 667-5131

Other names 1

  • Cameron Family Medicine-North Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dmattox8565@direct.parkviewexchange.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040323001008 IN Part B Supplier - Clinic/Group Practice 9234020835 Receives reassigned benefits from 136 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Angola, IN; Fremont, IN; Fort Wayne, IN
O20211018001516 IN Part A Provider - Rural Health Clinic 9234020835 Practice locations: Angola, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922671809. Details of each certification follow.

Rural health clinic certification: CCN 158570

Legal name
CAMERON MEMORIAL COMMUNITY HOSPITAL INC
Doing business as
CAMERON FAMILY MEDICINE - NORTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 14, 2022
Last certification
Dec 14, 2022
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Sep 26, 1972 in IN
Enrollment address
3250 Intertech Dr
Ste a
Angola, IN 46703-7224
Related CCNs
151315

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

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 6

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0988899Cameron Family Medicine - North Campus3250 Intertech Drive Suite a, Angola, IN 46703Certificate of waiverOct 25, 2027

National Provider Directory

National Provider Directory
Tax ID family
Cameron Memorial Community Hospital Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • Direct secure messaging: dmattox8565@direct.parkviewexchange.com

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Todd C Rumsey Individual Corporate OfficerTreasurer Sep 30, 2013
Ann Rice Individual Corporate Officer Apr 25, 2023
Wendy Jean Stamper Individual Corporate Director Apr 25, 2023
Jonathan Orlando Cress Individual Corporate Officer Apr 25, 2023
Michael Connell Individual Corporate Officer Apr 25, 2023
Deborah E McHenry Individual Corporate OfficerChair Sep 30, 2013
Lynn V Faur Individual Corporate Officer Apr 25, 2023
Thomas L Miller Individual Corporate Officer Apr 25, 2023
Janelle Sponsler Individual W-2 Managing Employee Apr 25, 2023
Angela M Logan Individual Corporate Officer Apr 25, 2023
W-2 Managing EmployeeCeo Oct 1, 2021
Jeffrey R Nickel Individual Corporate Officer Apr 25, 2023
Andrew Michael Aldred Individual Corporate Officer Apr 25, 2023
Donna K Elbrecht Individual Corporate Officer Apr 25, 2023
Cameron Memorial Community Hospital Inc Organization, Angola, IN Corporation, Non-profit 5% Or Greater Direct Ownership Interest Oct 1, 2021 100%
John McCoy Individual Corporate OfficerChair Sep 30, 2013

Owners & managing parties with NPI records 11

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Cameron Memorial Community Hospital IncAngola, IN, CCN 15Z315 Hospital Operational/Managerial Control Jan 1, 1989
Cameron Jointaccess Ortho & UrgentAngola, IN, CCN 158545 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 25, 2023
Cameron OB/GYNAngola, IN, CCN 158546 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 25, 2023
Cameron Family Medicine FremontFremont, IN, CCN 158571 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2023

Owned or controlled facilities with NPI records 5

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

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751846400000",
    "number": "1922671809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 E MAUMEE ST",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032015",
            "telephone_number": "260-667-5131",
            "fax_number": "260-665-7803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 INTERTECH DR STE A",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467037224",
            "telephone_number": "260-665-2646",
            "fax_number": "260-665-8707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMERON MEMORIAL COMMUNITY HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-20",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "260-667-5330"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dmattox8565@direct.parkviewexchange.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "3250 Intertech Dr Ste A",
            "city": "Angola",
            "state": "IN",
            "country_code": "US",
            "postal_code": "467037224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Cameron Family Medicine-North",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Angola, IN

Sources for this page

Verify at the official NPI Registry.