Lakeland Community Hospital, Inc.

Organization Active NPI Rural Health Clinic/Center · Haleyville, AL

NPI 1982162962 · NPPES record last updated Jun 19, 2026

Key facts

NPI
1982162962
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
LAKELAND COMMUNITY HOSPITAL, INC.
Practice address
42030 Highway 195 Ste a
Haleyville, AL 35565-7054
Phone
(205) 485-7227
Fax
(205) 485-7229
NPI assigned
Mar 8, 2019
Organization subpart
No

Authorized official

Name
Cherie Lynn Sibley, FACHE
Title
Chief Executive Officer
Phone
(205) 485-7152

Owners & managing parties with NPI records 2

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

Other NPIs with the same Medicare PAC ID 4

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

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

Facilities with the same owner 4

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

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AL

Rural health clinic certification: CCN 013477

Legal name
LAKELAND COMMUNITY HOSPITAL INC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 24, 2019
Last certification
Apr 1, 2026
Ownership / control type
2B
Organization structure
Corporation · Non-profit
Incorporated
Sep 17, 2014 in AL
Enrollment address
42030 Highway 195
Ste a
Haleyville, AL 35565-7054
Related CCNs
011311

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
Roger Dexter Hayes
Individual
Corporate Officer
Chairman
Jul 1, 2023 14.29%
Corporate Director Jan 1, 2023
Venkatapur Ramesh Reddy
Individual
5% Or Greater Indirect Ownership Interest Dec 28, 2018 14.29%
Amber James
Individual
Corporate Director Jan 1, 2025 14.29%
The Healthcare Authority of Haleyville and Winston County Alabama
Organization · Haleyville, AL
Non-profit
5% Or Greater Direct Ownership Interest Dec 28, 2018 100%
Cherie E Sibley
Individual
Corporate Officer
Secretary/Treasurer
Jul 1, 2023 14.29%
W-2 Managing Employee
Ad;
Mar 18, 2025
Barry Tidwell
Individual
Corporate Director Jan 1, 2025
Seth D Smothers
Individual
Corporate Director Dec 1, 2023 14.29%
Shannon Gregory Lollar
Individual
Corporate Director Jan 1, 2022

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20190605003093 AL Part a Provider - Rural Health Clinic 8224354618 Practice locations: Haleyville, AL

National Provider Directory

Locations

42024 Highway 195
Ste A
Haleyville, AL 35565
Phone (205) 485-7288

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EJHGBD

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X
Rural Health Clinic/Center 261QR1300X Yes

Addresses

Primary practice location

42030 Highway 195 Ste a
Haleyville, AL 35565-7054

Mailing address

42024 Highway 195 Ste a
Haleyville, AL 35565-7054
Phone (205) 485-7227

Other identifiers

IdentifierTypeStateIssuer
168737MedicaidAL

Other names

  • Lakeland Family Practice Doing business as

Other providers in Haleyville, AL

All providers in Haleyville, AL · Rural Health Clinic/Center in Alabama

Sources for this page

Verify at the official NPI Registry.