Irwin County Hospital

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

11-A544 Issued in GA

Legal business name

IRWIN COUNTY HOSPITAL

Doing business as

Palemon Gaskins Memorial Nursing Home

Practice address

201 W Dismuke Ave
Ocilla, GA 31774-1217

Phone

(229) 468-3890

Fax

(229) 468-3973

NPI assigned

Oct 4, 2005

Last updated

Feb 27, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Krystal Carver

Title

Cfo

Phone

(229) 468-3846

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Palemon Gaskins Memorial Nursing Home Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962499038. Details of each certification follow.

• CCN 115713 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 115713

Legal name

IRWIN COUNTY HOSPITAL

Doing business as

PALEMON GASKINS MEMORIAL NURSING HOME

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Dec 1, 2005

Last certification

Dec 22, 2024

Beds

30

Ownership / control type

County

Organization structure

OtherNon-profit

Enrollment address

201 West Dismuke Avenue
Ocilla, GA 31774-1217

Nursing home name

PALEMON GASKINS MEM NSG HOME

Other NPIs with the same Medicare PAC ID 1

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

• Irwin County Hospital

  • Rural Acute Care Hospital
  • Ocilla, GA
  • NPI 1720098791

  7618950643

  Same PAC ID

Listed as

Palemon Gaskins Mem NSG HomeCCN 115713 · All quality measures

Overall star rating

2 of 5

Health inspections

3 of 5

Staffing

1 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

Government - County

Certified

Dec 1, 2005

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

3024.5 residents per day on average

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

Tax ID family

Irwin Co Hospital8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

• Hospital Authority of Irwin County

  dba Broxton Family Medical

  • Primary Care Clinic/Center
  • Broxton, GA
  • NPI 1225689664
  NPD tax ID
• Hospital Authority of Irwin County

  dba Irwin Medical

  • Family Medicine Physician
  • Ocilla, GA
  • NPI 1518357607
  NPD tax ID
• Ich Physician Group

  dba Irwin Family Medicine

  • Rural Health Clinic/Center
  • Ocilla, GA
  • NPI 1437785995
  NPD tax ID
• Ich Physician Group

  dba Willacoochee Clinic

  • Rural Health Clinic/Center
  • Willacoochee, GA
  • NPI 1649670894
  NPD tax ID
• Irwin County Hospital

  dba Irwin Pediatrics

  • Pediatrics Physician
  • Ocilla, GA
  • NPI 1033595327
  NPD tax ID
• Irwin County Hospital

  dba Womens Center of Cypress Pond

  • Obstetrics & Gynecology Physician
  • Tifton, GA
  • NPI 1811397060
  NPD tax ID
• Irwin County Hospital

  dba Irwin General Surgery

  • Surgery Physician
  • Ocilla, GA
  • NPI 1982142956
  NPD tax ID

All disclosed owners & managing parties 2

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

All facility ownership & control disclosures 2

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

Owned or controlled facilities with NPI records 2

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

• Ich Physician Group

  dba Irwin Family Medicine

  • Rural Health Clinic/Center
  • Ocilla, GA
  • NPI 1437785995

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Ich Physician Group

  dba Willacoochee Clinic

  • Rural Health Clinic/Center
  • Willacoochee, GA
  • NPI 1649670894

  5% Or Greater Direct Ownership Interest

  CMS ownership

Practitioners 1

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.

• James Stanley Sinclair, M.D.

  • Internal Medicine Physician
  • Douglas, GA
  • NPI 1437142320
  NPD (past)

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740614400000",
    "number": "1962499038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W DISMUKE AVE",
            "city": "OCILLA",
            "state": "GA",
            "postal_code": "317741217",
            "telephone_number": "229-468-3890",
            "fax_number": "229-468-3973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W DISMUKE AVE",
            "city": "OCILLA",
            "state": "GA",
            "postal_code": "317741217",
            "telephone_number": "229-468-3890",
            "fax_number": "229-468-3973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRWIN COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A",
        "authorized_official_last_name": "CARVER",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "229-468-3846"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "11-A544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00142326A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF GA FACILITY ID #",
            "identifier": "11-A544",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palemon Gaskins Memorial Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Irwin County Anesthesia, Inc.
• Irwin County Board of Education
• Irwin County EMS
• Irwin County Hospital (Irwin Pediatrics)
• Irwin County Hospital
• Irwin County Hospital (Irwin General Surgery)
• Irwin Specialty Centers LLC
• Stepheny Natasha Meyokee Lott Jones
• Howard C McMahan, MD
• Antonio McRoy

• Skilled Nursing Facility in Ocilla, GA
• Providers in Ocilla, GA by specialty
• Skilled Nursing Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.