NPIMap

Organization Active NPI

Crockett Hospital LLC

Doing business as Southern Tennessee Regional Health System Lawrenceburg

  • Rural Acute Care Hospital
  • Lawrenceburg, TN
National Provider Identifier
1114003175
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
License
0000000087 Issued in TN
Legal business name
CROCKETT HOSPITAL LLC
Doing business as
Southern Tennessee Regional Health System Lawrenceburg
Practice address
1607 S Locust Ave
Lawrenceburg, TN 38464-4011
Phone
(931) 762-6571
Fax
(931) 766-3339
NPI assigned
Oct 31, 2006
Last updated
Apr 26, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Authorized official

Name
Terrance Dillon
Title
Assistant Secretary
Phone
(502) 596-7220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X 0000000087 TN Primary

Addresses

Primary practice location

1607 S Locust Ave
Lawrenceburg, TN 38464-4011

Mailing address

330 Seven Springs Way
Brentwood, TN 37027-4536
Phone (615) 920-7000

Other identifiers 5

IdentifierTypeStateIssuer
000171091XMedicaidGA
HOS0175NMedicaidAL
0440175MedicaidTN
09400008MedicaidMS
1762067MedicaidLA

Other names 1

  • Southern Tennessee Regional Health System Lawrenceburg Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address strhs-lawrenceburg@yourcarecommunity.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040814000037 TN Part A Provider - Hospital 7810960226 Practice locations: Lawrenceburg, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114003175. Details of each certification follow.

Hospital certification: CCN 440175

Legal name
CROCKETT HOSPITAL LLC
Doing business as
SOUTHERN TENNESSEE REGIONAL HEALTH SYSTEM LAWRENCEBURG
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jan 28, 1974
Last certification
Jul 11, 2018
Beds
96
Ownership / control type
Other
Most recent change of ownership
Feb 1, 1999 (1 total)
Organization structure
LLCProprietary
Incorporated
Nov 9, 1998 in DE
Enrollment address
1607 S Locust Ave
Lawrenceburg, TN 38464-4011
Other Hospital Practice Location
Hospital subgroups
Acute care, Rehabilitation

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

Other NPIs with the same Medicare PAC ID 2

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

  • Crockett Hospital LLC

    dba Southern Tennessee Regional Health System Lawrenceburg

    • Rehabilitation Hospital Unit
    • Lawrenceburg, TN
    • NPI 1790864288

    7810960226

    Same PAC ID
  • Crockett Hospital, LLC

    dba Southern Tennessee Regional Health System Lawrenceburg

    • Medicare Defined Swing Bed Hospital Unit
    • Lawrenceburg, TN
    • NPI 1720212038

    7810960226

    Same PAC ID

Care Compare: Hospital

Medicare Care Compare
Listed as
Southern Tennessee Regional Health System LawrenceCCN 440175 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Crockett Hospital4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Lifepoint Holdings 2 LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Direct Ownership Interest Jan 31, 1999 100%
Lifepoint Corporate Services General Partnership Organization, Brentwood, TN Operational/Managerial Control Jan 1, 2015
William Haugh Individual Corporate OfficerPresident Jan 25, 2022
DSB Acquisition LLC Organization, New York, NY LLC, Investment firm, For-profit 5% Or Greater Indirect Ownership Interest Nov 16, 2018 100%
Lifepoint Hospitals Holdings LLC Organization, Brentwood, TN For-profit 5% Or Greater Indirect Ownership Interest Feb 1, 1999 100%
Historic Lifepoint Hospitals, LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest Feb 1, 1999 100%
Daniel Davis Individual Corporate OfficerCfo Jun 24, 2019
Lifepoint Health Inc Organization, Brentwood, TN Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Nov 16, 2018 100%
Marcus B Poppell Individual Corporate OfficerSenior Vice President Nov 2, 2009
Other Feb 1, 1999
Charlotte E Lawrence Individual Corporate OfficerSecretary Jan 25, 2022
Eric Rhee Perry Individual Operational/Managerial ControlFacility Ceo Jan 6, 2025
John Michael Grooms Individual Corporate OfficerSenior Vice President & Treasurer Nov 1, 2016
Christopher J Monte Individual Corporate OfficerVice President Jul 27, 2005
Legacy Lifepoint Health LLC Organization, Brentwood, TN LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Feb 24, 2022 100%

Facilities with the same owner 195

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

  • Amg-Crockett LLC

    dba Summertown Medical Center

    • Rural Health Clinic/Center
    • Mt Pleasant, TN
    • NPI 1255069639

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC

    CMS ownership
  • Amg-Crockett, LLC

    dba First Choice Health Lawrenceburg

    • Rural Health Clinic/Center
    • Lawrenceburg, TN
    • NPI 1023840998

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC

    CMS ownership
  • Amg-Crockett, LLC

    dba Southern Tennessee Internal Medicine - Lawrenceburg

    • Rural Health Clinic/Center
    • Lawrenceburg, TN
    • NPI 1417739640

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC

    CMS ownership
  • Amg-Crockett, LLC

    dba First Choice Health Loretto

    • Rural Health Clinic/Center
    • Loretto, TN
    • NPI 1811543929

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC

    CMS ownership
  • Amg-Crockett, LLC

    dba Women's Health Clinic

    • Rural Health Clinic/Center
    • Lawrenceburg, TN
    • NPI 1891580858

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC

    CMS ownership
  • Amg-Hillside LLC

    dba Southern Tennessee Family Health - Pulaski

    • Rural Health Clinic/Center
    • Pulaski, TN
    • NPI 1063294296

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC

    CMS ownership
  • Amg-Hillside LLC

    dba Southern Tennessee Primary Care Eastside

    • Rural Health Clinic/Center
    • Pulaski, TN
    • NPI 1144052002

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC

    CMS ownership
  • Amg-Hillside LLC

    dba Southern Tennessee Primary Care Lynnville

    • Rural Health Clinic/Center
    • Lynnville, TN
    • NPI 1407688369

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC

    CMS ownership
  • Amg-Hillside LLC

    dba Southern Tennessee Primary Care Ardmore

    • Rural Health Clinic/Center
    • Ardmore, TN
    • NPI 1558117028

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC

    CMS ownership
  • Amg-Hillside LLC

    dba First Choice Health - Pulaski

    • Rural Health Clinic/Center
    • Pulaski, TN
    • NPI 1568190551

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC

    CMS ownership
  • Amg-Hillside LLC

    dba Southern Tennessee Primary Care Cornersville

    • Rural Health Clinic/Center
    • Lewisburg, TN
    • NPI 1881426740

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC

    CMS ownership
  • Amg-Southern Tennessee LLC

    dba Highpoint Family Wellness - Winchester with Ascension Saint Thomas

    • Rural Health Clinic/Center
    • Winchester, TN
    • NPI 1063140051

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC

    CMS ownership
View all 195

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 184

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

View all 184

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650931200000",
    "number": "1114003175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274536",
            "telephone_number": "615-920-7000",
            "fax_number": "615-920-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 S LOCUST AVE",
            "city": "LAWRENCEBURG",
            "state": "TN",
            "postal_code": "384644011",
            "telephone_number": "931-762-6571",
            "fax_number": "931-766-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROCKETT HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A",
        "authorized_official_last_name": "DILLON",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "502-596-7220"
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "TN",
            "license": "0000000087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000171091X",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HOS0175N",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0440175",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09400008",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1762067",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "strhs-lawrenceburg@yourcarecommunity.org",
            "affiliation": "N",
            "address_1": "1607 S Locust Ave",
            "city": "Lawrenceburg",
            "state": "TN",
            "country_code": "US",
            "postal_code": "384644011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Southern Tennessee Regional Health System Lawrenceburg",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Tennessee Regional Health System Lawrenceburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawrenceburg, TN

Sources for this page

Verify at the official NPI Registry.