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Organization Active NPI

Wilkes Barre Hospital Company LLC

Doing business as Wilkes Barre General Hospital

  • Rehabilitation Hospital Unit
  • Wilkes Barre, PA
National Provider Identifier
1104126317
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
WILKES BARRE HOSPITAL COMPANY LLC
Doing business as
Wilkes Barre General Hospital
Practice address
575 N River St
Wilkes Barre, PA 18702-2634
Phone
(570) 829-8111
Fax
(570) 552-3030
NPI assigned
Oct 22, 2010
Last updated
Apr 26, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
WILKES BARRE HOSPITAL COMPANY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Authorized official

Name
Paula Lalor
Title
Director/Delegated Official
Phone
(629) 215-3953

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X Primary

Addresses

Primary practice location

575 N River St
Wilkes Barre, PA 18702-2634

Mailing address

575 N River St
Wilkes Barre, PA 18764
Phone (570) 829-8111

Other names 1

  • Wilkes Barre General Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110217000749 PA Part A Provider - Hospital 5890845754 Practice locations: Wilkes Barre, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104126317. Details of each certification follow.

Hospital certification: CCN 39T137

Legal name
WILKES BARRE HOSPITAL COMPANY LLC
Doing business as
WILKES BARRE GENERAL HOSPITAL
Organization structure
LLCProprietary
Incorporated
Oct 30, 2008 in DE
Enrollment address
575 N River St
Wilkes Barre General Hospital
Wilkes Barre, PA 18764-0999
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

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

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Center for Advanced RehabCCN 39T137 · All quality measures
Ownership
For profit
Certified
Jul 1, 2011

National Provider Directory

National Provider Directory
Tax ID family
Wilkes Barre Hospital Company LLC5 organizations share this tax ID, including this one
Part of
Wilkes Barre Hospital Company LLC

Other organizations with this tax ID 4

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

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Kevin J Hammons Individual Corporate OfficerPresident/Board Member Mar 1, 2022
Corporate DirectorPresident/Board Member Mar 1, 2022
Nathaniel K Summar Individual Corporate DirectorVP Revenue Management Jul 15, 2017
Justin D Pitt Individual Corporate OfficerExec VP/Assist Sec/Board Member Mar 1, 2022
Corporate DirectorExec VP/Assist Sec/Board Member Mar 1, 2022
Simon Ratliff Individual W-2 Managing EmployeeCeo Sep 1, 2022
William Bradley Cash Individual Corporate OfficerExec VP Mar 1, 2022
Hma-Tri Holdings LLC Organization, Franklin, TN LLC 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Community Health Systems Inc Organization, Franklin, TN Corporation 5% Or Greater Indirect Ownership Interest May 1, 2009 100%
Jason Kevin Johnson Individual Corporate OfficerSenior VP Jan 6, 2020
Roman Gabriel Ottinger Individual Corporate OfficerSenior VP / Treasurer Jan 6, 2020
Triad Healthcare, LLC Organization, Franklin, TN LLC 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Wilkes-Barre Holdings LLC Organization, Franklin, TN LLC 5% Or Greater Direct Ownership Interest May 1, 2009 100%
Paula M Lalor Individual Corporate DirectorDirector PFS Apr 1, 2017
Tennyson Holdings LLC Organization, Franklin, TN LLC 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Edna S Buffington-Price Individual Corporate DirectorVP/Authorized Official Mar 1, 2022
Scranton Holdings LLC Organization, Franklin, TN LLC 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Christopher G Cobb Individual Corporate OfficerVP/Secretary Mar 1, 2022
CHS Community Health Systems Inc Organization, Franklin, TN Corporation 5% Or Greater Indirect Ownership Interest May 1, 2009 100%

Facilities with the same owner 120

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

  • Scranton Hospital Company LLC

    dba Regional Hospital of Scranton

    • General Acute Care Hospital
    • Scranton, PA
    • NPI 1881983039

    CHS Community Health Systems Inc, Community Health Systems Inc, Hma-Tri Holdings LLC, Scranton Holdings LLC, Tennyson Holdings LLC

    CMS ownership
  • Affinity Hospital LLC

    dba Grandview Medical Center

    • General Acute Care Hospital
    • Birmingham, AL
    • NPI 1023061405

    CHS Community Health Systems Inc, Community Health Systems Inc, Hma-Tri Holdings LLC, Tennyson Holdings LLC

    CMS ownership
  • Affinity Hospital LLC

    dba Grandview Medical Center

    • Psychiatric Hospital Unit
    • Birmingham, AL
    • NPI 1043263221

    CHS Community Health Systems Inc, Community Health Systems Inc, Hma-Tri Holdings LLC, Tennyson Holdings LLC

    CMS ownership
  • Affinity Hospital LLC

    dba Grandview Medical Center

    • Rehabilitation Hospital Unit
    • Birmingham, AL
    • NPI 1720001019

    CHS Community Health Systems Inc, Community Health Systems Inc, Hma-Tri Holdings LLC, Tennyson Holdings LLC

    CMS ownership
  • Bluffton Health System LLC

    dba Bluffton Regional Medical Center

    • Medicare Defined Swing Bed Hospital Unit
    • Bluffton, IN
    • NPI 1356839591

    CHS Community Health Systems Inc, Community Health Systems Inc, Hma-Tri Holdings LLC, Tennyson Holdings LLC

    CMS ownership
  • Bluffton Health System LLC

    dba Bluffton Regional Medical Center

    • General Acute Care Hospital
    • Bluffton, IN
    • NPI 1376594366

    CHS Community Health Systems Inc, Community Health Systems Inc, Hma-Tri Holdings LLC, Tennyson Holdings LLC

    CMS ownership
  • Brandon Hma LLC

    dba Merit Health Rankin

    • General Acute Care Hospital
    • Brandon, MS
    • NPI 1205882669

    CHS Community Health Systems Inc, Community Health Systems Inc, Hma-Tri Holdings LLC

    CMS ownership
  • Brandon Hma LLC

    dba Merit Health Rankin

    • Psychiatric Hospital Unit
    • Brandon, MS
    • NPI 1427098391

    CHS Community Health Systems Inc, Community Health Systems Inc, Hma-Tri Holdings LLC

    CMS ownership
  • Bullhead City Hospital Corporation

    dba Western Arizona Regional Medical Center

    • General Acute Care Hospital
    • Bullhead City, AZ
    • NPI 1255302766

    CHS Community Health Systems Inc, Community Health Systems Inc

    CMS ownership
  • Campbell County Hma LLC
    • Skilled Nursing Facility
    • La Follette, TN
    • NPI 1023099447

    CHS Community Health Systems Inc, Community Health Systems Inc, Hma-Tri Holdings LLC

    CMS ownership
  • Campbell County Hma LLC

    dba Tennova Primary Care Caryville

    • Rural Health Clinic/Center
    • Caryville, TN
    • NPI 1023613361

    CHS Community Health Systems Inc, Community Health Systems Inc, Hma-Tri Holdings LLC

    CMS ownership
  • Campbell County Hma LLC

    dba Tennova Primary Care Clinton

    • Rural Health Clinic/Center
    • Clinton, TN
    • NPI 1093300717

    CHS Community Health Systems Inc, Community Health Systems Inc, Hma-Tri Holdings LLC

    CMS ownership
View all 120

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1287705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619395200000",
    "number": "1104126317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 N RIVER ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "18764",
            "telephone_number": "570-829-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 N RIVER ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187022634",
            "telephone_number": "570-829-8111",
            "fax_number": "570-552-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILKES BARRE HOSPITAL COMPANY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WILKES BARRE HOSPITAL COMPANY LLC",
        "enumeration_date": "2010-10-22",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A",
        "authorized_official_last_name": "LALOR",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "DIRECTOR/DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "629-215-3953"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilkes Barre General Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.