NPIMap

Organization Active NPI

J. Arthur Dosher Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Southport, NC
National Provider Identifier
1992934137
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
H0150 Issued in NC
Legal business name
J. ARTHUR DOSHER MEMORIAL HOSPITAL
Practice address
924 N Howe St
Southport, NC 28461-3038
Phone
(910) 457-3800
Fax
(910) 457-3931
NPI assigned
Jul 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Authorized official

Name
Brandon Hughes
Title
Finance Director
Phone
(910) 454-4728

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X H0150 NC Primary

Addresses

Primary practice location

924 N Howe St
Southport, NC 28461-3038

Mailing address

924 N Howe St
Southport, NC 28461-3038
Phone (910) 457-3800

Other identifiers 1

IdentifierTypeStateIssuer
3451327MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220829000284 NC Part A Provider - Critical Access Hospital 8921910324 Receives reassigned benefits from 1 practitioner
Practice locations: Southport, NC

Hospital certification: CCN 34Z327

Legal name
J. ARTHUR DOSHER MEMORIAL HOSPITAL
Organization structure
CorporationNon-profit
Enrollment address
924 N Howe St
Southport, NC 28461-3038
Main/Primary Hospital Location

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

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Robert M Zukoski Individual Corporate Director Nov 1, 2009
Joseph Agovino Individual Corporate Director Nov 1, 2009
Thomas R Siemers Individual Corporate OfficerCeo Nov 5, 2012
Debbie M Barnes Individual Corporate Director Nov 1, 2009
James W Woody Individual Corporate Director Nov 1, 2009
Sharon Marshall Individual Corporate Director Nov 1, 2009
Don M Hughes Individual Corporate Director Nov 4, 2009
Karen Taylor Individual Corporate Director Nov 1, 2011
Dennis Coffey Individual Corporate Director Nov 1, 2009
W-2 Managing Employee Nov 1, 2009

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Dosher Memorial HospitalSouthport, NC, CCN 341327 Hospital Operational/Managerial Control Nov 1, 2009
Dosher Wellness CenterSouthport, NC, CCN 343465 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017

Owned or controlled facilities with NPI records 5

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

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 3

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": "1247097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613433600000",
    "number": "1992934137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 N HOWE ST",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284613038",
            "telephone_number": "910-457-3800",
            "fax_number": "910-457-3931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 N HOWE ST",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284613038",
            "telephone_number": "910-457-3800",
            "fax_number": "910-457-3931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. ARTHUR DOSHER MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-09",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A",
        "authorized_official_last_name": "HUGHES",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "910-454-4728"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NC",
            "license": "H0150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3451327",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southport, NC

Sources for this page

Verify at the official NPI Registry.