NPIMap

Organization Active NPI

Martin Health

Doing business as West Tennessee Healthcare Volunteer Hospital

  • General Acute Care Hospital
  • Martin, TN
National Provider Identifier
1275505372
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
MARTIN HEALTH
Doing business as
West Tennessee Healthcare Volunteer Hospital
Practice address
161 Mount Pelia Rd
Martin, TN 38237-3811
Phone
(731) 587-4261
Fax
(731) 588-3209
NPI assigned
Feb 2, 2006
Last updated
Oct 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Authorized official

Name
Ms. Tina Prescott
Title
President and Ceo
Phone
(731) 541-5000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 0000000126 TN
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

161 Mount Pelia Rd
Martin, TN 38237-3811

Mailing address

161 Mount Pelia Rd
Martin, TN 38237-3811
Phone (731) 587-4261

Other identifiers 7

IdentifierTypeStateIssuer
01600824MedicaidKY
136771MedicaidTN
421557527OtherCHAMPUS
044-0061MedicaidTN
0440061MedicaidTN
25795MedicaidTN
4048507OtherBCBS

Other names 1

  • West Tennessee Healthcare Volunteer Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180730001063 TN Part A Provider - Hospital 5193070613 Practice locations: Martin, TN; South Fulton, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1275505372. Details of each certification follow.

Hospital certification: CCN 440061

Legal name
MARTIN HEALTH
Doing business as
WEST TENNESSEE HEALTHCARE VOLUNTEER HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jan 26, 1995
Beds
100
Ownership / control type
Private (for profit)
Most recent change of ownership
Jun 1, 2018 (3 total)
Organization structure
CorporationNon-profit
Enrollment address
161 Mount Pelia Rd
Martin, TN 38237-3811
Main/Primary Hospital Location
Hospital subgroups
General

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

Other NPIs with the same Medicare PAC ID 3

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

  • Martin Health

    dba West Tennessee Medical Group Hillview South Clinic

    • Rural Health Clinic/Center
    • South Fulton, TN
    • NPI 1669876520

    5193070613

    Same PAC ID
  • Martin Health

    dba West Tennessee Healthcare Volunteer Hospital

    • Medicare Defined Swing Bed Hospital Unit
    • Martin, TN
    • NPI 1821060930

    5193070613

    Same PAC ID
  • Martin Health

    dba West Tennessee Medical Group Primary Care Martin

    • Rural Health Clinic/Center
    • Martin, TN
    • NPI 1871034462

    5193070613

    Same PAC ID

Care Compare: Hospital

Medicare Care Compare
Listed as
Volunteer Community HospitalCCN 440061 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Martin Health5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

  • Martin Health

    dba West Tennessee Healthcare Volunteer Hospital Pharmacy

    • Pharmacy
    • Martin, TN
    • NPI 1093582496
    NPD tax ID
  • Martin Health

    dba West Tennessee Medical Group Hillview South Clinic

    • Rural Health Clinic/Center
    • South Fulton, TN
    • NPI 1669876520
    NPD tax ID
  • Martin Health

    dba West Tennessee Healthcare Volunteer Hospital

    • Medicare Defined Swing Bed Hospital Unit
    • Martin, TN
    • NPI 1821060930
    NPD tax ID
  • Martin Health

    dba West Tennessee Medical Group Primary Care Martin

    • Rural Health Clinic/Center
    • Martin, TN
    • NPI 1871034462
    NPD tax ID

Locations

161 Mount Pelia Rd
Martin, TN 38237
Phone (731) 587-4261

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Jeffrey D Blankenship Individual Corporate OfficerVP and Cfo Apr 12, 2018
W-2 Managing EmployeeVP and Cfo Apr 12, 2018
Jackson Madison County General Hospital Organization, Jackson, TN Non-profit Operational/Managerial Control Jan 2, 2019
Martin Health Organization, Jackson, TN Created for acquisition, Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jun 1, 2018 100%
Tina Prescott Individual Corporate OfficerPresident and Ceo Sep 12, 2024
W-2 Managing EmployeePresident and Ceo Sep 12, 2024

Owners & managing parties with NPI records 11

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
West Tennessee Healthcare Volunteer HospitalMartin, TN, CCN 44U061 Hospital 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2018
West Tennessee Medical Group Primary Care MartinMartin, TN, CCN 443452 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2018
West Tennessee Medical Group Hillview South ClinicSouth Fulton, TN, CCN 443449 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2018

Owned or controlled facilities with NPI records 3

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

  • Martin Health

    dba West Tennessee Medical Group Hillview South Clinic

    • Rural Health Clinic/Center
    • South Fulton, TN
    • NPI 1669876520

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Martin Health

    dba West Tennessee Healthcare Volunteer Hospital

    • Medicare Defined Swing Bed Hospital Unit
    • Martin, TN
    • NPI 1821060930

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Martin Health

    dba West Tennessee Medical Group Primary Care Martin

    • Rural Health Clinic/Center
    • Martin, TN
    • NPI 1871034462

    5% Or Greater Direct Ownership Interest

    CMS ownership

Facilities with the same owner 15

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

View all 15

Practitioners & affiliated clinicians

Practitioners 16

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 16

Affiliated clinicians 190

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

View all 190

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728864000000",
    "number": "1275505372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 MOUNT PELIA RD",
            "city": "MARTIN",
            "state": "TN",
            "postal_code": "382373811",
            "telephone_number": "731-587-4261",
            "fax_number": "731-588-3209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 MOUNT PELIA RD",
            "city": "MARTIN",
            "state": "TN",
            "postal_code": "382373811",
            "telephone_number": "731-587-4261",
            "fax_number": "731-588-3209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-02",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A",
        "authorized_official_last_name": "PRESCOTT",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "731-541-5000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TN",
            "license": "0000000126",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01600824",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136771",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "421557527",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044-0061",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0440061",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25795",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4048507",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Tennessee Healthcare Volunteer Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Martin, TN

Sources for this page

Verify at the official NPI Registry.