NPIMap

Organization Active NPI

Piedmont Mountainside Hospital, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Jasper, GA
National Provider Identifier
1053371138
Registry record updated May 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
112-619 Issued in GA
Legal business name
PIEDMONT MOUNTAINSIDE HOSPITAL, INC
Practice address
1266 Highway 515 S
Jasper, GA 30143-4872
Phone
(706) 301-5269
Fax
(706) 692-0939
NPI assigned
Mar 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2012

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

Authorized official

Name
Mr. Ed Lovern
Title
Ceo
Phone
(706) 301-5269

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 112-619 GA Primary

Addresses

Primary practice location

1266 Highway 515 S
Jasper, GA 30143-4872

Mailing address

1266 Highway 515 S
Patient Financial Services
Jasper, GA 30143-4872
Phone (706) 301-5269

Other identifiers 1

IdentifierTypeStateIssuer
00001493SMedicaidGA

Other names 1

  • Piedmont Mountainside Hosptial Swing Bed Unit Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

15 Reinhardt College Pkwy
Ste 110B
Canton, GA 30114
Phone (770) 720-3353

309 Highland Pkwy
Ste 100
Ellijay, GA 30540
Phone (706) 635-1680

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338336000000",
    "number": "1053371138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1266 HIGHWAY 515 S",
            "address_2": "PATIENT FINANCIAL SERVICES",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301434872",
            "telephone_number": "706-301-5269",
            "fax_number": "706-692-0939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1266 HIGHWAY 515 S",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301434872",
            "telephone_number": "706-301-5269",
            "fax_number": "706-692-0939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT MOUNTAINSIDE HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-24",
        "last_updated": "2012-05-30",
        "status": "A",
        "authorized_official_last_name": "LOVERN",
        "authorized_official_first_name": "ED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-301-5269",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "GA",
            "license": "112-619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00001493S",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Piedmont Mountainside Hosptial Swing Bed Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jasper, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.