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Johnston Memorial Hospital, Inc

Organization Active NPI General Acute Care Hospital · Abingdon, VA

NPI 1104812684 · NPPES record last updated May 29, 2025

Key facts

NPI
1104812684
Entity type
Organization (NPI type 2)
Primary specialty
General Acute Care Hospital 282N00000X
License
H1864 (VA)
Legal business name
JOHNSTON MEMORIAL HOSPITAL, INC
Practice address
16000 Johnston Memorial Dr
Abingdon, VA 24211-7664
Phone
(276) 258-1000
Fax
(276) 258-2805
NPI assigned
Sep 21, 2005
Organization subpart
No

Authorized official

Name
Shane Edwin Hilton
Title
Evp/Cfo
Phone
(423) 302-3467

Owners & managing parties with NPI records 21

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

Member of 1

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

Member organizations 1

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

Facilities with the same owner 41

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

View all 41

Practitioners 87

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

View all 87

Affiliated clinicians 516

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

View all 516

Medicare Care Compare: Hospital

Listed as
Johnston Memorial Hospital CCN 490053
Overall star rating
★★★☆☆ 3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in VA

Hospital certification: CCN 490053

Legal name
JOHNSTON MEMORIAL HOSPITAL INC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Apr 18, 2018
Beds
116
Ownership / control type
Private (not for profit)
Organization structure
Corporation · Non-profit
Incorporated
Jul 10, 1917 in VA
Enrollment address
16000 Johnston Memorial Dr
Abingdon, VA 24211-7664
Other Hospital Practice Location
Hospital subgroups
General, Acute care

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Shane Hilton
Individual 		Corporate Officer
Evp/Cfo		 Apr 4, 2024
Corporate Director
Evp/Cfo		 Apr 4, 2024
Gregory Wilgocki
Individual 		Corporate Director
SVP		 Feb 1, 2018
W-2 Managing Employee
SVP		 Feb 1, 2018
Ballad Health
Organization · Abingdon, VA
Corporation, Non-profit 		5% Or Greater Indirect Ownership Interest Feb 1, 2018 100%
Marvin Eichorn
Individual 		Corporate Officer
Evp/Cao		 Feb 1, 2018
Corporate Director
Board Member		 Feb 1, 2018
Mountain States Health Alliance
Organization · Johnson City, TN
Corporation, Non-profit 		5% Or Greater Direct Ownership Interest Nov 10, 2021 100%
Buford Deaton
Individual 		Corporate Officer
Evp/Coo		 Feb 1, 2018
Corporate Director
Board Member		 Feb 1, 2018
Alan Levine
Individual 		Corporate Officer
Ceo/President		 Feb 1, 2018
Corporate Director
Board Member		 Feb 1, 2018
Julie Bennett
Individual 		Corporate Officer
Evp/Clo		 Feb 1, 2023
Corporate Director
Board Member		 Feb 1, 2023

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20071210000249 VA Part a Provider - Hospital 6103725668 Practice locations: Abingdon, VA; Marion, VA; Bristol, VA
O20230427002467 VA Part B Supplier - Intensive Cardiac Rehabilitation 6103725668 Practice locations: Abingdon, VA

National Provider Directory

Locations

445 Porterfield Hwy SW
Ste B
Abingdon, VA 24210
Phone (276) 263-0153

613 Campus Dr
Abingdon, VA 24210
Phone (276) 258-1480

16000 Johnston Memorial Dr
Ste 209
Abingdon, VA 24211
Phone (276) 258-2760

103 North St
Ste A
Bristol, VA 24201
Phone (276) 642-7901

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X
General Acute Care Hospital 282N00000X H1864 VA Yes

Addresses

Primary practice location

16000 Johnston Memorial Dr
Abingdon, VA 24211-7664

Mailing address

311 Princeton Rd Ste 1
Johnson City, TN 37601-2026
Phone (276) 258-1000

Other identifiers

IdentifierTypeStateIssuer
142849OtherVABLUE CROSS REF. LAB
CB9307OtherVARR MEDICARE
1104812684MedicaidVA
007658OtherVAANTHEM BLUE CROSS

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://67.32.31.88:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other JOHNSTON MEMORIAL HOSPITAL, INC

Other providers in Abingdon, VA

All providers in Abingdon, VA · General Acute Care Hospital in Virginia

Sources for this page

Verify at the official NPI Registry.