NPIMap

Organization Active NPI

Cookeville Regional Medical Center

  • General Acute Care Hospital
  • Cookeville, TN
National Provider Identifier
1275531956
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
0000000095 Issued in TN
Legal business name
COOKEVILLE REGIONAL MEDICAL CENTER
Practice address
1 Medical Center Blvd
Cookeville, TN 38501-1760
Phone
(931) 783-2602
Fax
(931) 783-5666
NPI assigned
Jul 7, 2005
Last updated
Jun 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Authorized official

Name
Marilyn C Key
Title
Ceo
Phone
(931) 783-2481

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 0000000095 TN Primary

Addresses

Primary practice location

1 Medical Center Blvd
Cookeville, TN 38501-1760

Mailing address

1 Medical Center Blvd
Cookeville, TN 38501-1760
Phone (931) 783-2602

Other identifiers 27

IdentifierTypeStateIssuer
1000116OtherTNBLUE CROSS PROVIDER #
3067323OtherTNAMERIGROUP PIN # FOR PROFESSIONAL BILLING
3870577OtherTNAMERIGROUP PIN # FOR PROFESSIONAL BILLING
4042505OtherTNBCBST&TNCARE PIN PROF FEE
1000116OtherTNTENNCARE PROVIDER ID #
3071971OtherTNAMERIGROUP PIN # FOR PROFESSIONAL BILLING
3079003OtherTNBCBST&TNCARE PIN PROF FEE
3836719OtherTNAMERIGROUP PIN # FOR PROFESSIONAL BILLING
4109479OtherTNBCBST&TNCARE PIN PROF FEE
TN0104OtherTNAMERICHOICE PIN # FOR PROFESSIONAL BILLING
0064651OtherTNAETNA PROVIDER ID #
3088600OtherTNBCBST&TNCARE PIN PROF FEE
369882OtherTNAMERICHOICE PIN # FOR PROFESSIONAL BILLING
3806863OtherTNAMERIGROUP PIN # FOR PROFESSIONAL BILLING
4139913OtherTNBCBST&TNCARE PIN PROF FEE
0440059MedicaidTN
27478OtherTNAMERIGROUP PIN # FOR PROFESSIONAL BILLING
369883OtherTNAMERICHOICE PIN # FOR PROFESSIONAL BILING
4123672OtherTNBCBST&TNCARE PIN PROF FEE
3091395OtherTNAMERIGROUP PIN # FOR PROFESSIONAL BILLING
4119802OtherTNBCBST&TNCARE PIN PROF FEE
3064481OtherTNAMERIGROUP PIN # FOR PROFESSIONAL BILLING
3088599OtherTNBCBST&TNCARE PIN PROF FEE
3163698OtherTNBCBST&TNCARE PIN PROF FEE
3894633OtherTNAMERIGROUP PIN # FOR PROFESSIONAL BILLING
4088879OtherTNBCBST&TNCARE PIN PROF FEE
5000408OtherTNUHC PROVIDER ID #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20030108000032 TN Part A Provider - Hospital 7810805736 Practice locations: Cookeville, TN
O20040921001310 TN Part B Supplier - Clinic/Group Practice 7810805736 Receives reassigned benefits from 153 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cookeville, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1275531956. Details of each certification follow.

Hospital certification: CCN 440059

Legal name
COOKEVILLE REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Aug 25, 1999
Beds
269
Ownership / control type
Local
Organization structure
OtherNon-profit
Enrollment address
1 Medical Center Blvd
Cookeville, TN 38501-4294
Main/Primary Hospital Location
Hospital subgroups
General, Short-term

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

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Cookeville Regional Medical CenterCCN 440059 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Justin David Cumby Individual Corporate DirectorBoard Member Jun 1, 2024
Alma Anderson Individual Corporate DirectorBoard Member Oct 24, 2022
Scott Anthony Copeland Individual Corporate DirectorBoard Member Aug 1, 2021
Bert E Geer Individual Corporate DirectorBoard Member Aug 1, 2024
Joseph Paul Albrecht Individual Corporate DirectorBoard Member Aug 1, 2025
Marilyn C Key Individual Corporate OfficerCeo May 1, 2023
W-2 Managing EmployeeCeo May 1, 2023
Operational/Managerial ControlCeo May 1, 2023
Danny Rader Individual Corporate DirectorBoard Member Aug 1, 2020
Laurin R Wheaton Individual Corporate DirectorBoard Member Jan 1, 2021 10%
Jack W Carey Individual Corporate DirectorBoard Member Jun 4, 1980
Randel Wallace Individual Corporate DirectorBoard Member Aug 1, 2023

Owners & managing parties with NPI records 3

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

Subparts reporting this organization as parent 4

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 61

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 61

Affiliated clinicians 576

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

View all 576

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687305600000",
    "number": "1275531956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385011760",
            "telephone_number": "931-783-2602",
            "fax_number": "931-783-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385011760",
            "telephone_number": "931-783-2602",
            "fax_number": "931-783-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOKEVILLE REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A",
        "authorized_official_last_name": "KEY",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "931-783-2481"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TN",
            "license": "0000000095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "1000116",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP PIN # FOR PROFESSIONAL BILLING",
            "identifier": "3067323",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP PIN # FOR PROFESSIONAL BILLING",
            "identifier": "3870577",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST&TNCARE PIN PROF FEE",
            "identifier": "4042505",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNCARE PROVIDER ID #",
            "identifier": "1000116",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP PIN # FOR PROFESSIONAL BILLING",
            "identifier": "3071971",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST&TNCARE PIN PROF FEE",
            "identifier": "3079003",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP PIN # FOR PROFESSIONAL BILLING",
            "identifier": "3836719",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST&TNCARE PIN PROF FEE",
            "identifier": "4109479",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE PIN # FOR PROFESSIONAL BILLING",
            "identifier": "TN0104",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER ID #",
            "identifier": "0064651",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST&TNCARE PIN PROF FEE",
            "identifier": "3088600",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE PIN # FOR PROFESSIONAL BILLING",
            "identifier": "369882",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP PIN # FOR PROFESSIONAL BILLING",
            "identifier": "3806863",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST&TNCARE PIN PROF FEE",
            "identifier": "4139913",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0440059",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP PIN # FOR PROFESSIONAL BILLING",
            "identifier": "27478",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE PIN # FOR PROFESSIONAL BILING",
            "identifier": "369883",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST&TNCARE PIN PROF FEE",
            "identifier": "4123672",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP PIN # FOR PROFESSIONAL BILLING",
            "identifier": "3091395",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST&TNCARE PIN PROF FEE",
            "identifier": "4119802",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP PIN # FOR PROFESSIONAL BILLING",
            "identifier": "3064481",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST&TNCARE PIN PROF FEE",
            "identifier": "3088599",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST&TNCARE PIN PROF FEE",
            "identifier": "3163698",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP PIN # FOR PROFESSIONAL BILLING",
            "identifier": "3894633",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST&TNCARE PIN PROF FEE",
            "identifier": "4088879",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC PROVIDER ID #",
            "identifier": "5000408",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.