NPIMap

Organization Active NPI

Cookeville Regional Medical Center

  • Home Health Agency
  • Cookeville, TN
National Provider Identifier
1083683155
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
0000000197 Issued in TN
Legal business name
COOKEVILLE REGIONAL MEDICAL CENTER
Practice address
1101 Neal St Ste 103
Cookeville, TN 38501-0917
Phone
(931) 783-2941
Fax
(931) 783-2566
NPI assigned
Mar 14, 2006
Organization subpart
Yes
Parent organization
COOKEVILLE REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Authorized official

Name
Marilyn C Key
Title
Ceo
Phone
(931) 783-2481

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 0000000197 TN Primary

Addresses

Primary practice location

1101 Neal St Ste 103
Cookeville, TN 38501-0917

Mailing address

1101 Neal St Ste 103
Cookeville, TN 38501-0917
Phone (931) 528-5578

Other names 1

  • Cookeville Regional Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080611000059 TN Part A Provider - Home Health Agency 7810805736 Practice locations: Cookeville, TN

Home health agency certification: CCN 447131

Legal name
COOKEVILLE REGIONAL MEDICAL CENTER
Doing business as
COOKEVILLE REGIONAL HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 23, 1978
Last certification
Dec 7, 2017
Ownership / control type
Non-Profit
Organization structure
OtherNon-profit
Enrollment address
1101 Neal St
Ste 103
Cookeville, TN 38501-0917
HHA Branch

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Cookeville Regional Home HealthCCN 447131
Overall star rating
3.5 of 5
Ownership
Non-Profit
Certified
May 23, 1978
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D0681828Cookeville Regional Medical Center1101 Neal Street, Cookeville, TN 38501Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Cookeville Gen Hospital2 organizations share this tax ID, including this one
Part of
Cookeville Gen Hospital

Other organizations with this tax ID 1

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

Locations

2370 Quinland Lake Rd
Ste 150
Cookeville, TN 38506
Phone (931) 201-9682

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Justin David Cumby Individual Corporate DirectorBoard Member Jun 1, 2024
Alma Anderson Individual Corporate Director Oct 24, 2022
Scott Anthony Copeland Individual Corporate Director Oct 24, 2022
Bert E Geer Individual Corporate DirectorBoard Member Aug 1, 2024
Joseph Paul Albrecht Individual Corporate DirectorBoard Member Aug 1, 2025
Marilyn C Key Individual Corporate OfficerCeo May 1, 2023
W-2 Managing EmployeeCeo May 1, 2023
Operational/Managerial ControlCeo May 1, 2023
Danny Rader Individual Corporate DirectorBoard Member Aug 1, 2020
Laurin R Wheaton Individual Corporate DirectorBoard Member Jan 1, 2021 10%
Jack W Carey Individual Corporate DirectorBoard Member Oct 1, 2025
Randel Wallace Individual Corporate DirectorBoard Member Aug 1, 2023

Owners & managing parties with NPI records 3

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 52

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

View all 52

Affiliated clinicians 18

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1083683155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 NEAL ST STE 103",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385010917",
            "telephone_number": "931-528-5578",
            "fax_number": "931-783-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 NEAL ST STE 103",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385010917",
            "telephone_number": "931-783-2941",
            "fax_number": "931-783-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOKEVILLE REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COOKEVILLE REGIONAL MEDICAL CENTER",
        "enumeration_date": "2006-03-14",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "KEY",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "931-783-2481"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TN",
            "license": "0000000197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cookeville Regional Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.