NPIMap

Organization Active NPI

Coliseum Medical Center, LLC

  • Rehabilitation Hospital Unit
  • Macon, GA
National Provider Identifier
1275587263
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
COLISEUM MEDICAL CENTER, LLC
Practice address
C/O Coliseum Health System
350 Hospital Drive
Macon, GA 31217
Phone
(478) 765-7000
Fax
(478) 742-1247
NPI assigned
May 22, 2006
Organization subpart
Yes
Parent organization
COLISEUM MEDICAL CENTER, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Authorized official

Name
Robert C Cross
Title
VP Government Reimbursement
Phone
(470) 271-3401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X Primary

Addresses

Primary practice location

C/O Coliseum Health System
350 Hospital Drive
Macon, GA 31217

Mailing address

350 Hospital Dr
Macon, GA 31217-3838
Phone (478) 765-7000

Other names 1

  • Piedmont Macon Medical Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service Other Ciox Health

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070607000194 GA Part A Provider - Hospital 6406819572 Practice locations: Macon, GA

Hospital certification: CCN 11T164

Legal name
COLISEUM MEDICAL CENTER LLC
Doing business as
PIEDMONT MACON MEDICAL CENTER
Organization structure
LLCNon-profit
Enrollment address
350 Hospital Dr
Macon, GA 31217-3838
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

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).

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Piedmont Macon Rehabilitation CenterCCN 11T164
Ownership
Non-profit
Certified
Apr 1, 1994

National Provider Directory

National Provider Directory
Tax ID family
Coliseum Health System3 organizations share this tax ID, including this one
Part of
Coliseum Health System

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Thomas Arnold Individual Corporate Officer Aug 1, 2021
Michael J Mandl Individual Corporate Officer Aug 1, 2021
Piedmont Macon Hospital Inc Organization, Atlanta, GA Created for acquisition, Corporation, Holding company, Non-profit 5% Or Greater Direct Ownership Interest Aug 1, 2021 100%
Alisha R Neal Individual W-2 Managing EmployeeCfo Aug 1, 2021
Piedmont Healthcare Inc Organization, Atlanta, GA Corporation, Non-profit Operational/Managerial Control Aug 1, 2021 100%
Robert C Cross Individual Corporate Officer Aug 1, 2021
Elizabeth Leddy Individual Corporate Officer Aug 1, 2021

Owners & managing parties with NPI records 1

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

Facilities with the same owner 29

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

View all 29

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

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

Affiliated clinicians 5

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

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708905600000",
    "number": "1275587263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 HOSPITAL DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173838",
            "telephone_number": "478-765-7000",
            "fax_number": "478-742-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "C/O COLISEUM HEALTH SYSTEM",
            "address_2": "350 HOSPITAL DRIVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31217",
            "telephone_number": "478-765-7000",
            "fax_number": "478-742-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLISEUM MEDICAL CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLISEUM MEDICAL CENTER, LLC",
        "enumeration_date": "2006-05-22",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VP GOVERNMENT REIMBURSEMENT",
        "authorized_official_telephone_number": "470-271-3401"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "esmd.cioxhealth.com and OID is '2.16.840.1.113883.3.6635.1.1'",
            "affiliationName": "Ciox Health",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "925 N Point Pkwy",
            "city": "Alpharetta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300055210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Piedmont Macon Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.