NPIMap

Organization Active NPI

Holmes County Hospital Corp

Doing business as Bonifay Rural Health Clinic

  • Rural Health Clinic/Center
  • Bonifay, FL
National Provider Identifier
1952917015
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HOLMES COUNTY HOSPITAL CORP
Doing business as
Bonifay Rural Health Clinic
Practice address
2910 Hospital Dr Ste a
Bonifay, FL 32425-4268
Phone
(850) 547-8158
NPI assigned
Sep 23, 2020
Last updated
Sep 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Authorized official

Name
Huy Nguyen, M.D.NPI 1396797155
Title
Chief Executive Officer
Phone
(850) 547-8003

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary
Nurse Practitioner 363L00000X NU
Family Nurse Practitioner 363LF0000X NU
Pediatric Nurse Practitioner 363LP0200X NU
Women's Health Nurse Practitioner 363LW0102X NU
Occupational Health Nurse Practitioner 363LX0106X NU

Addresses

Primary practice location

2910 Hospital Dr Ste a
Bonifay, FL 32425-4268

Mailing address

PO Box 188
Bonifay, FL 32425-0188
Phone (850) 547-8003

Other names 1

  • Bonifay Rural Health Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20101122001377 FL Part B Supplier - Clinic/Group Practice 3375557887 Receives reassigned benefits from 56 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bonifay, FL
O20201123000128 FL Part A Provider - Rural Health Clinic 3375557887 Practice locations: Bonifay, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1952917015. Details of each certification follow.

Rural health clinic certification: CCN 103462

Legal name
HOLMES COUNTY HOSPITAL CORP
Doing business as
BONIFAY RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 31, 2020
Last certification
Mar 5, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
2910 Hospital Dr
Ste a
Bonifay, FL 32425-4268
Related CCNs
101307

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

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 2

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
10D2203226Bonifay Rural Health Clinic2910 Hospital Drive, Suite a, Bonifay, FL 32425Certificate of waiverDec 2, 2026

National Provider Directory

National Provider Directory
Tax ID family
Doctors Memorial Hosp3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Holmes County Hospital Corp Organization, Bonifay, FL Corporation, Non-profit 5% Or Greater Direct Ownership Interest Dec 31, 2020 100%
Cynthia Brooks Individual Corporate OfficerBoard Member Sep 1, 2020
Rohan Anderson Individual Operational/Managerial ControlCeo Jan 28, 2025
Jennie Goodman Individual Corporate OfficerBoard Member Sep 1, 2020
Jerry Dixon Individual Corporate OfficerBoard Member Sep 1, 2020

Owners & managing parties with NPI records 1

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

Change-of-ownership history 1

DateEventCounterparty
Dec 31, 2020 Change of OwnershipThis provider was the buyer Southern Health ClinicCCN 683804, FL, NPI 1962596122

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 55

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 55

NPI Registry JSON

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1952917015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "BONIFAY",
            "state": "FL",
            "postal_code": "324250188",
            "telephone_number": "850-547-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 HOSPITAL DR STE A",
            "city": "BONIFAY",
            "state": "FL",
            "postal_code": "324254268",
            "telephone_number": "850-547-8158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLMES COUNTY HOSPITAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-23",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "HUY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "850-547-8003",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bonifay Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bonifay, FL

Sources for this page

Verify at the official NPI Registry.