NPIMap

Organization Active NPI

Shamrock Community Hospital Inc.

Doing business as Houston County Community Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Erin, TN
National Provider Identifier
1952011520
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
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
(336) 944-6420
NPI assigned
Dec 5, 2022
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
Medicare Defined Swing Bed Hospital Unit 275N00000X NU 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
Q082116MedicaidTN

Other names 1

  • Houston County Community Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230302002860 TN Part A Provider - Critical Access Hospital 8325422082 1 other NPI on this enrollment
Practice locations: Erin, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1952011520. Details of each certification follow.

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.

National Provider Directory

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
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 InterestCeo Braden Health Aug 1, 2022
Corporate Officer Aug 1, 2022
Corporate Director Aug 1, 2022
William Lomax Individual W-2 Managing EmployeeAd; Feb 1, 2023
Brooks Braden Individual 5% Or Greater Direct Ownership InterestCoo Braden Health Aug 1, 2022
Joseph Rivera Individual Corporate DirectorCto Aug 1, 2022
Larry Henson Individual Corporate OfficerRCD, Authorized Official Aug 1, 2022
Richard D Matthews Individual Corporate DirectorCmo Aug 1, 2022
Kyle Kopec Individual 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 66

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 66

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722470400000",
    "number": "1952011520",
    "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": "336-944-6420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAMROCK COMMUNITY HOSPITAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-05",
        "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": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q082116",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Houston County Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "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.