Public record

CMS Home Health Agency All Owners

Associate id: 4183604259 · 19 matching records

Enrollment id
O20070224000104
Associate id
4183604259
Organization name
CARILION TAZEWELL COMMUNITY HOSPITAL
Associate id - owner
0648693200
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2023-10-01
First name - owner
ALICIA
Last name - owner
BALES
Title - owner
HOSPITAL SENIOR DIRECTOR/CEO
Enrollment id
O20070224000104
Associate id
4183604259
Organization name
CARILION TAZEWELL COMMUNITY HOSPITAL
Associate id - owner
0840245221
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2010-01-01
First name - owner
GEORGE
Middle name - owner
ROBERT
Last name - owner
VAUGHAN
Title - owner
TREASURER
Enrollment id
O20070224000104
Associate id
4183604259
Organization name
CARILION TAZEWELL COMMUNITY HOSPITAL
Associate id - owner
1951444215
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2015-07-28
First name - owner
JAMES
Last name - owner
THOMPSON
Title - owner
CHAIR MEMBER BOARD OF DIRECTORS
Enrollment id
O20070224000104
Associate id
4183604259
Organization name
CARILION TAZEWELL COMMUNITY HOSPITAL
Associate id - owner
3375834096
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2015-07-28
First name - owner
KRISTIE
Middle name - owner
G
Last name - owner
WILLIAMS
Title - owner
HOSPITAL VICE PRESIDENT BODIRECT
Enrollment id
O20070224000104
Associate id
4183604259
Organization name
CARILION TAZEWELL COMMUNITY HOSPITAL
Associate id - owner
3476822370
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2017-01-01
First name - owner
MANDY
Last name - owner
FRENCH
Enrollment id
O20070224000104
Associate id
4183604259
Organization name
CARILION TAZEWELL COMMUNITY HOSPITAL
Associate id - owner
4183604259
Type - owner
O
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2021-09-30
Organization name - owner
CARILION TAZEWELL COMMUNITY HOSPITAL
Doing business as name - owner
CARILION CLINIC
Address line 1 - owner
141 BEN BOLT AVE
City - owner
TAZEWELL
State - owner
VA
Zip code - owner
246519700
Corporation - owner
Y
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
Y
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Enrollment id
O20070224000104
Associate id
4183604259
Organization name
CARILION TAZEWELL COMMUNITY HOSPITAL
Associate id - owner
4284057845
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2021-10-01
First name - owner
NELLIE
Middle name - owner
MARIE
Last name - owner
STILLWELL
Enrollment id
O20070224000104
Associate id
4183604259
Organization name
CARILION TAZEWELL COMMUNITY HOSPITAL
Associate id - owner
4385120096
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2025-10-14
First name - owner
ELEANOR
Last name - owner
PRESCOTT
Title - owner
DIRECTOR OF PAYER CONTRACTING COORD
Enrollment id
O20070224000104
Associate id
4183604259
Organization name
CARILION TAZEWELL COMMUNITY HOSPITAL
Associate id - owner
4688065691
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2025-10-06
First name - owner
JOSHUA
Last name - owner
HARTLE
Title - owner
DIRECTOR OF PROVIDER ENROLLMENT
Enrollment id
O20070224000104
Associate id
4183604259
Organization name
CARILION TAZEWELL COMMUNITY HOSPITAL
Associate id - owner
4789634049
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2012-01-17
First name - owner
DONALD
Middle name - owner
B
Last name - owner
HALLIWILL
Enrollment id
O20070224000104
Associate id
4183604259
Organization name
CARILION TAZEWELL COMMUNITY HOSPITAL
Associate id - owner
5890935928
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2015-07-28
First name - owner
MICHAEL
Middle name - owner
D
Last name - owner
HYMES
Title - owner
BOARD OF DIRECTORS MEMEBER
Enrollment id
O20070224000104
Associate id
4183604259
Organization name
CARILION TAZEWELL COMMUNITY HOSPITAL
Associate id - owner
6103195003
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2017-01-01
First name - owner
ANTHONY
Last name - owner
GRILLS
Enrollment id
O20070224000104
Associate id
4183604259
Organization name
CARILION TAZEWELL COMMUNITY HOSPITAL
Associate id - owner
6204975071
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2015-07-01
First name - owner
WILLIAM
Middle name - owner
J
Last name - owner
FLATTERY
Title - owner
MEMEBR OF BOARD OF DIRECTOR
Enrollment id
O20070224000104
Associate id
4183604259
Organization name
CARILION TAZEWELL COMMUNITY HOSPITAL
Associate id - owner
6305215856
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2022-09-30
First name - owner
MICHAEL
Last name - owner
HOOPS
Enrollment id
O20070224000104
Associate id
4183604259
Organization name
CARILION TAZEWELL COMMUNITY HOSPITAL
Associate id - owner
6305746843
Type - owner
O
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2021-09-30
Organization name - owner
CARILION CLINIC
Doing business as name - owner
OTHER NAME
Address line 1 - owner
213 S JEFFERSON ST
Address line 2 - owner
STE 625
City - owner
ROANOKE
State - owner
VA
Zip code - owner
240111713
Corporation - owner
Y
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
Y
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Enrollment id
O20070224000104
Associate id
4183604259
Organization name
CARILION TAZEWELL COMMUNITY HOSPITAL
Associate id - owner
6507894367
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2021-10-01
First name - owner
MARK
Middle name - owner
W
Last name - owner
MOSSEY
Enrollment id
O20070224000104
Associate id
4183604259
Organization name
CARILION TAZEWELL COMMUNITY HOSPITAL
Associate id - owner
7517352453
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2021-10-01
First name - owner
DONALD
Last name - owner
LINKOUS
Enrollment id
O20070224000104
Associate id
4183604259
Organization name
CARILION TAZEWELL COMMUNITY HOSPITAL
Associate id - owner
8729482450
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2025-12-01
First name - owner
JUNETTA
Middle name - owner
N
Last name - owner
BOWEN
Title - owner
MEMBER, BOARD OF DIRECTORS
Enrollment id
O20070224000104
Associate id
4183604259
Organization name
CARILION TAZEWELL COMMUNITY HOSPITAL
Associate id - owner
9537523170
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2023-05-22
First name - owner
KIMBERLY
Last name - owner
REYNOLDS

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