NPIMap

Organization Active NPI

T J Samson Community Hospital

Doing business as T J Samson Hospice

  • Community Based Hospice Care Agency
  • Glasgow, KY
National Provider Identifier
1376574806
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
400039 Issued in KY
Legal business name
T J SAMSON COMMUNITY HOSPITAL
Doing business as
T J Samson Hospice
Practice address
1301 N Race St
Glasgow, KY 42141-3454
Phone
(270) 651-4430
Fax
(270) 651-4862
NPI assigned
Jul 5, 2006
Last updated
Mar 30, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
T J REGIONAL HEALTH INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Authorized official

Name
Neil Thornbury
Title
Ceo
Phone
(270) 651-4159

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 400039 KY Primary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X NU

Addresses

Primary practice location

1301 N Race St
Glasgow, KY 42141-3454

Mailing address

PO Box 645996
Cincinnati, OH 45264-5996
Phone (270) 651-4444

Other practice location 1

1020 Glenview Drive
Glasgow, KY 42141-3424
Phone (270) 659-3300

Other identifiers 2

IdentifierTypeStateIssuer
44000024MedicaidKY
000000348141OtherKYANTHEM PROVIDER NUMBER

Other names 1

  • T J Samson Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101021000778 KY Part A Provider - Hospice 0648182600 Practice locations: Glasgow, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376574806. Details of each certification follow.

Hospice certification: CCN 181531

Legal name
T J SAMSON COMMUNITY HOSPITAL
Doing business as
T J SAMSON HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 10, 2003
Last certification
Mar 12, 2020
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 30, 1974 in KY
Enrollment address
1301 N Race St
Glasgow, KY 42141-3454

Other NPIs with the same Medicare PAC ID 7

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

Care Compare: Hospice

Medicare Care Compare
Listed as
T J Samson Community Hospital Home Care HospiceCCN 181531 · All quality measures
Ownership
For-Profit
Certified
Dec 10, 2003
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
T J Samson Community Hospi15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

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
Thomas Rich Alexander Individual Corporate DirectorBoard Member Oct 1, 2015
Ladonna G Rogers Individual Corporate OfficerEvp Human Resources Jan 1, 2020
Shara Page Individual W-2 Managing EmployeeAd; Feb 1, 2024
Stacey Biggs Individual Corporate OfficerEvp Marketing Jan 1, 2020
Neil C Thornbury Individual Corporate OfficerCeo Jan 1, 2020
W-2 Managing EmployeeCeo Jan 1, 2020
Jodie Holgate Individual Corporate OfficerEvp Patient Care Services Jan 1, 2020
Bo Matthews Individual Corporate DirectorBoard Member Jan 1, 2020
TJ Regional Health Inc Organization, Glasgow, KY Non-profit Operational/Managerial Control Jan 1, 2011
Ervin Sorrell Individual Corporate DirectorBoard Member Jan 1, 2020
Michael S Young Individual Corporate DirectorBoard Member Jan 1, 2015
Brent Billingsley Individual Corporate DirectorBoard Member Jan 1, 2020
Brandon Dickey Individual Corporate OfficerEvp / Cno Aug 28, 2020
James Lee Individual Corporate OfficerEvp Support Services Jan 1, 2020
Mei Deng Individual Corporate OfficerCfo Jan 1, 2020
Cornelius Faulkner Individual Corporate DirectorBoard Member May 1, 2022
Cherie Kerney Individual W-2 Managing EmployeeOperations Coordinator Jun 1, 2013
Operational/Managerial Control Jun 1, 2013
Amy N Norris-Cassady Individual Corporate DirectorBoard Member May 1, 2022
Michael Andrew Saridakis Individual Corporate DirectorVice Chief of Staff Jan 1, 2021
Daniel Foutch Individual Corporate DirectorBoard Member Jan 1, 1999
Jennifer Cerwinske Individual Corporate OfficerEvp Practice Management Jan 1, 2020
Joseph Botts Individual Corporate DirectorBoard Member Jan 1, 2020
Henry Royse Individual Corporate DirectorBoard Member Jan 1, 1998
Kylend Hollie Kiser Individual Corporate DirectorChief of Staff Jan 1, 2021
W-2 Managing EmployeeMD; Jan 1, 2026

Owners & managing parties with NPI records 3

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

Facilities with the same owner 12

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

Practitioners & affiliated clinicians

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": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1376574806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 645996",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452645996",
            "telephone_number": "270-651-4444",
            "fax_number": "270-651-4892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N RACE ST",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421413454",
            "telephone_number": "270-651-4430",
            "fax_number": "270-651-4862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1020 Glenview Drive",
            "address_purpose": "LOCATION",
            "city": "Glasgow",
            "state": "KY",
            "postal_code": "421413424",
            "country_code": "US",
            "telephone_number": "270-659-3300",
            "fax_number": "270-659-3314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "T J SAMSON COMMUNITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "T J REGIONAL HEALTH INC",
        "enumeration_date": "2006-07-05",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "THORNBURY",
        "authorized_official_first_name": "NEIL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "270-651-4159"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "KY",
            "license": "400039",
            "primary": true
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44000024",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000348141",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "T J Samson Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "T J Samson Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glasgow, KY

Sources for this page

Verify at the official NPI Registry.