NPIMap

Organization Active NPI

Casey County Hospital District

  • Critical Access Hospital
  • Liberty, KY
National Provider Identifier
1407829567
Registry record updated Feb 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
600060 Issued in KY
Legal business name
CASEY COUNTY HOSPITAL DISTRICT
Practice address
187 Wolford Ave
Liberty, KY 42539-3187
Phone
(606) 787-6275
Fax
(606) 787-0251
NPI assigned
Feb 9, 2006
Last updated
Feb 26, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2019

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

Authorized official

Name
Rex A Tungate
Title
Ceo Adminitstrator
Phone
(606) 787-6275

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X
Critical Access Hospital 282NC0060X 600060 KY Primary

Addresses

Primary practice location

187 Wolford Ave
Liberty, KY 42539-3187

Mailing address

187 Wolford Ave
Liberty, KY 42539-3187
Phone (606) 787-6275

Other identifiers 2

IdentifierTypeStateIssuer
01000280MedicaidKY
65941304MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031110000044 KY Part B Supplier - Clinic/Group Practice 0749193423 Receives reassigned benefits from 29 practitioners
2 other NPIs on this enrollment
Practice locations: Liberty, KY
O20080118000633 KY Part A Provider - Critical Access Hospital 0749193423 Receives reassigned benefits from 11 practitioners
Practice locations: Liberty, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407829567. Details of each certification follow.

Hospital certification: CCN 181309

Legal name
CASEY COUNTY HOSPITAL DISTRICT
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Apr 15, 2001
Last certification
Dec 1, 2015
Beds
24
Ownership / control type
Hospital district or authority
Most recent change of ownership
Sep 15, 2003 (1 total)
Organization structure
OtherNon-profit
Enrollment address
187 Wolford Ave
Liberty, KY 42539-3278
Other Hospital Practice Location

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).

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
Casey County HospitalCCN 181309 · All quality measures
Overall star rating
3 of 5
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Casey County Primary Care Nursing Group8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/caseyco-4151b385

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
Casey County Hospital District Organization, Liberty, KY 5% Or Greater Direct Ownership Interest Nov 19, 2007 100%
Rex Tungate Individual Corporate OfficerCeo Nov 17, 2007
W-2 Managing Employee Nov 15, 2016
Tungate Healthcare Enterprises Inc Organization, Campbellsville, KY Management services company Operational/Managerial Control Jan 29, 2009
Karen Atwood Individual Corporate OfficerSecretary/Treasurer May 10, 2011
Ronald Wright Individual Corporate OfficerChairman Feb 1, 2018
Robert T Rousey Individual Corporate DirectorTrustee Oct 13, 2015
Dan Johnson Individual Corporate OfficerTrustee Nov 1, 2019

Owners & managing parties with NPI records 3

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
Casey County Hospital Swing Bed UnitLiberty, KY, CCN 18Z309 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 19, 2007
Casey County Primary CareLiberty, KY, CCN 183428 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 19, 2007
Casey County Family PracticeLiberty, KY, CCN 183466 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 29, 2009

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 29

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 29

Affiliated clinicians 48

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

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551139200000",
    "number": "1407829567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 WOLFORD AVE",
            "city": "LIBERTY",
            "state": "KY",
            "postal_code": "425393187",
            "telephone_number": "606-787-6275",
            "fax_number": "606-787-0251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 WOLFORD AVE",
            "city": "LIBERTY",
            "state": "KY",
            "postal_code": "425393187",
            "telephone_number": "606-787-6275",
            "fax_number": "606-787-0251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASEY COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-09",
        "last_updated": "2019-02-26",
        "status": "A",
        "authorized_official_last_name": "TUNGATE",
        "authorized_official_first_name": "REX",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO ADMINITSTRATOR",
        "authorized_official_telephone_number": "606-787-6275"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "KY",
            "license": "600060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01000280",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65941304",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, KY

Sources for this page

Verify at the official NPI Registry.