NPIMap

Organization Active NPI

John D Archbold Memorial Hospital Inc

Doing business as Archbold Memorial

  • General Acute Care Hospital
  • Thomasville, GA
National Provider Identifier
1194779702
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
136-91 Issued in GA
Legal business name
JOHN D ARCHBOLD MEMORIAL HOSPITAL INC
Doing business as
Archbold Memorial
Practice address
915 Gordon Ave
Thomasville, GA 31792-6614
Phone
(229) 228-2000
NPI assigned
May 19, 2006
Last updated
Apr 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Authorized official

Name
Mr. Gregory S. Hembree
Title
Cfo
Phone
(229) 228-2880

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X
General Acute Care Hospital 282N00000X 136-91 GA Primary
General Acute Care Hospital 282N00000X

Addresses

Primary practice location

915 Gordon Ave
Thomasville, GA 31792-6614

Mailing address

920 Cairo Rd
Thomasville, GA 31792-4255
Phone (229) 228-8800

Other practice location 1

114 Mimosa Dr Ste D
Thomasville, GA 31792-6679
Phone (229) 228-2839

Other practice location 2

2705 E Pinetree Blvd Ste A
Thomasville, GA 31792-4875
Phone (229) 228-4136

Other practice location 3

919 S Broad St
Thomasville, GA 31792-6114
Phone (229) 584-5400

Other practice location 4

947 S Broad St
Thomasville, GA 31792-6161
Phone (229) 228-3731

Other practice location 5

2300 E Pinetree Blvd
Thomasville, GA 31792-4825
Phone (229) 228-8050

Other identifiers 4

IdentifierTypeStateIssuer
000000063AMedicaidGA
110038A000000OtherGATRAILBLAZER
000020OtherGABC/BS GA
267978700MedicaidFL

Other names 1

  • Archbold Memorial Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, CO, TX, KY, DC, MA, MI, CA, LA, PR12 enrollments

Enrollment records 12

Enrollment IDStateProvider typePAC IDDetails
O20031117000138 GA Part B Supplier - Clinic/Group Practice 6002724598 Receives reassigned benefits from 59 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Griffin, GA; Smyrna, GA; Savannah, GA; Richmond Hill, GA; Pelham, GA; Peachtree City, GA; Newnan, GA; Atlanta, GA…
O20031219000506 GA Part B Supplier - Clinic/Group Practice 4981502622 Receives reassigned benefits from 110 practitioners
1 other NPI on this enrollment
Practice locations: Moultrie, GA; Newnan, GA; Peachtree City, GA; Quitman, GA; Richmond Hill, GA; Savannah, GA; Smyrna, GA; Thomasville, GA…
O20070627000694 GA Part A Provider - Hospital 4981502622 1 other NPI on this enrollment
Practice locations: Thomasville, GA; Bainbridge, GA; Camilla, GA; Quitman, GA
O20250430001855 CO Part B Supplier - Clinic/Group Practice 4981502622 Receives reassigned benefits from 2 practitioners
Practice locations: Denver, CO; Longmont, CO
O20250506000585 TX Part B Supplier - Clinic/Group Practice 4981502622 Receives reassigned benefits from 2 practitioners
Practice locations: North Richland Hills, TX; Beaumont, TX
O20250709001211 KY Part B Supplier - Clinic/Group Practice 4981502622 Receives reassigned benefits from 1 practitioner
Practice locations: Louisville, KY
O20250912002602 DC Part B Supplier - Clinic/Group Practice 4981502622 Receives reassigned benefits from 1 practitioner
Practice locations: Vienna, VA
O20250919000258 MA Part B Supplier - Clinic/Group Practice 4981502622 Receives reassigned benefits from 1 practitioner
Practice locations: Arlington, MA
O20250926001680 MI Part B Supplier - Clinic/Group Practice 4981502622 Receives reassigned benefits from 1 practitioner
Practice locations: Troy, MI
O20251013001136 CA Part B Supplier - Clinic/Group Practice 4981502622 Receives reassigned benefits from 1 practitioner
Practice locations: Carmel, CA
O20260115000087 LA Part B Supplier - Clinic/Group Practice 4981502622 Receives reassigned benefits from 1 practitioner
Practice locations: Belle Chasse, LA
O20260331004120 PR Part B Supplier - Clinic/Group Practice 4981502622 Receives reassigned benefits from 1 practitioner
Practice locations: Carolina, PR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194779702. Details of each certification follow.

Hospital certification: CCN 110038

Legal name
JOHN D ARCHBOLD MEMORIAL HOSPITAL INC
Doing business as
ARCHBOLD MEMORIAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jul 26, 1990
Beds
264
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
May 2, 1983 in GA
Enrollment address
915 Gordon Ave
Thomasville, GA 31792-6614
Main/Primary Hospital Location
Hospital subgroups
Acute care

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

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Archbold Memorial HospitalCCN 110038 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

1062 Forsyth St
Ste 3A
Macon, GA 31201
Phone (478) 743-4622

103 E Davis St
Quitman, GA 31643
Phone (229) 263-7868

10629 US Highway 19 S
Thomasville, GA 31792
Phone (229) 226-8942

210 W Hansell St
Thomasville, GA 31792
Phone (229) 228-8050

2300 E Pinetree Blvd
Thomasville, GA 31792
Phone (229) 228-8050

401 Old Albany Rd
Ste A
Thomasville, GA 31792
Phone (229) 228-8190

920 Cairo Rd
#864
Thomasville, GA 31792

920 Cairo Rd
Ste A
Thomasville, GA 31792

1610 John Orr Dr
Ste F
Tifton, GA 31794
Phone (229) 388-0800

Ownership & related parties

All disclosed owners & managing parties 23

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

NameRoleSinceShare
Andrea Kidd Collins Individual Corporate DirectorBoard Member Feb 25, 2025
Craig R Wentworth Individual Corporate DirectorBoard Member Jul 1, 2021
Patricia L Barrett Individual W-2 Managing EmployeeDirector Sep 1, 2006
Carla Pearce Individual Corporate OfficerChief Accounting Officer Jul 1, 2021
W-2 Managing EmployeeChief Accounting Officer Jul 1, 2021
Brian J Szwarc Individual Corporate DirectorBoard Member Oct 1, 2021
Sina E. Griffith Individual Corporate DirectorBoard Member Oct 1, 2021
Jason Odell Burnette Individual Corporate DirectorBoard Member Mar 1, 2025
Josh David Simmons Individual Corporate DirectorBoard Member Jan 1, 2023
Henry a. Stone Individual Corporate DirectorBoard Member Oct 1, 2021
Timothy Eric Ward Individual Corporate Director Feb 25, 2025
Karen L Bramblett Individual Corporate DirectorBoard Member Jan 1, 2023
Darcy M Craven Individual Corporate OfficerPresident and Ceo Aug 24, 2020
W-2 Managing EmployeePresident and Ceo Aug 24, 2020
Joe S Carnline Individual Corporate DirectorBoard Member Jan 1, 2023
Ashley T. Cason Individual Corporate DirectorBoard Member Jan 1, 2023
Christopher L Daniels Individual Corporate DirectorBoard Member Mar 1, 2025
Loren Rials Individual W-2 Managing EmployeeSVP/Cfo Aug 18, 2025
Marvin E. Dawson Individual Corporate DirectorBoard Member Jan 1, 2023
William G Hamil Individual Corporate DirectorBoard Member Jan 28, 2023
Jami Porter Individual Corporate DirectorBoard Member Jan 1, 2023
Archbold Medical Center Inc Organization, Thomasville, GA Non-profit 5% Or Greater Direct Ownership Interest Dec 20, 2006 100%
Gregory Hembree Individual Corporate OfficerSenior Vice President/Cfo Dec 5, 2016
W-2 Managing EmployeeSenior Vice President/Cfo Dec 5, 2016
Jacquelyn V. Santoro Individual Corporate DirectorBoard Member Jan 1, 2023
Jason M Nesmith Individual Corporate DirectorBoard Member Oct 1, 2021

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 13

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Archbold Brooks SwingbedQuitman, GA, CCN 11Z332 Hospital Operational/Managerial Control Jun 1, 1987
Archbold GradyCairo, GA, CCN 110121 Hospital Operational/Managerial Control Apr 26, 2007
Archbold Grady SwingbedCairo, GA, CCN 11U121 Hospital Operational/Managerial Control Apr 26, 2007
Archbold MitchellCamilla, GA, CCN 111331 Hospital Operational/Managerial Control Jul 2, 1990
Archbold Mitchell SwingbedCamilla, GA, CCN 11Z331 Hospital Operational/Managerial Control Dec 20, 2006
Archbold BrooksQuitman, GA, CCN 111332 Hospital Operational/Managerial Control Jun 11, 1987
Mitchell County Nursing HomesCamilla, GA, CCN 115266 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 1, 1990
Oct 1, 1990
Archbold Living ThomasvilleThomasville, GA, CCN 115480 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jul 1, 1994
Apr 11, 2025
Archbold Living CairoCairo, GA, CCN 115776 Skilled nursing facility Adp of the SNF
Indirect Ownership Interest (100%)		 Jun 19, 2025
Sep 26, 2023
Hospice of Southwest GeorgiaThomasville, GA, CCN 111521 Hospice 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2023
Jan 1, 2023
Archbold Pediatrics CamillaCamilla, GA, CCN 113474 Rural health clinic Operational/Managerial Control (100%) May 29, 2014
Archbold Primary Care CamillaCamilla, GA, CCN 118519 Rural health clinic Operational/Managerial Control (100%) Jul 2, 1990
Archbold Primary Care PelhamPelham, GA, CCN 118544 Rural health clinic Operational/Managerial Control (100%) Aug 26, 2013

Owned or controlled facilities with NPI records 16

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 16

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 163

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.

View all 163

Affiliated clinicians 333

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

View all 333

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745971200000",
    "number": "1194779702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 CAIRO RD",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317924255",
            "telephone_number": "229-228-8800",
            "fax_number": "229-228-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 GORDON AVE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926614",
            "telephone_number": "229-228-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 Mimosa Dr Ste D",
            "address_purpose": "LOCATION",
            "city": "Thomasville",
            "state": "GA",
            "postal_code": "317926679",
            "country_code": "US",
            "telephone_number": "229-228-2839",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2705 E Pinetree Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Thomasville",
            "state": "GA",
            "postal_code": "317924875",
            "country_code": "US",
            "telephone_number": "229-228-4136",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "919 S Broad St",
            "address_purpose": "LOCATION",
            "city": "Thomasville",
            "state": "GA",
            "postal_code": "317926114",
            "country_code": "US",
            "telephone_number": "229-584-5400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "947 S Broad St",
            "address_purpose": "LOCATION",
            "city": "Thomasville",
            "state": "GA",
            "postal_code": "317926161",
            "country_code": "US",
            "telephone_number": "229-228-3731",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2300 E Pinetree Blvd",
            "address_purpose": "LOCATION",
            "city": "Thomasville",
            "state": "GA",
            "postal_code": "317924825",
            "country_code": "US",
            "telephone_number": "229-228-8050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JOHN D ARCHBOLD MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-22",
        "status": "A",
        "authorized_official_last_name": "HEMBREE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "229-228-2880",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "GA",
            "license": "136-91",
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000063A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAILBLAZER",
            "identifier": "110038A000000",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS GA",
            "identifier": "000020",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267978700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Archbold Memorial",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Archbold Memorial",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Thomasville, GA

Sources for this page

Verify at the official NPI Registry.