NPIMap

Organization Active NPI

Piedmont Athens Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Athens, GA
National Provider Identifier
1437186111
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
029-007 Issued in GA
Legal business name
PIEDMONT ATHENS REGIONAL MEDICAL CENTER, INC.
Practice address
1199 Prince Avenue
Athens, GA 30606
Phone
(706) 475-7000
Fax
(706) 475-5940
NPI assigned
Jun 27, 2006
Last updated
Feb 26, 2024By the provider in NPPES
Organization subpart
No

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
Mr. Robert C Cross
Title
VP, Government Reimbursement
Phone
(470) 271-3401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 029-007 GA Primary

Addresses

Primary practice location

1199 Prince Avenue
Athens, GA 30606

Mailing address

1199 Prince Avenue
Athens, GA 30606
Phone (706) 475-7000

Other identifiers 1

IdentifierTypeStateIssuer
00000074AMedicaidGA

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 GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040309000481 GA Part B Supplier - Clinic/Group Practice 6800784067 Receives reassigned benefits from 27 practitioners
1 other NPI on this enrollment
Practice locations: Athens, GA
O20080221000587 GA Part A Provider - Hospital 6800784067 Practice locations: Athens, GA; Watkinsville, GA; Royston, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1437186111. Details of each certification follow.

Hospital certification: CCN 110074

Legal name
PIEDMONT ATHENS REGIONAL MEDICAL CENTER, INC.
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Apr 10, 2025
Beds
315
Ownership / control type
Other
Most recent change of ownership
Jul 1, 1995 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Jun 30, 1995 in GA
Enrollment address
1199 Prince Ave
Athens, GA 30606-2797
Main/Primary Hospital Location
Hospital subgroups
Acute care

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 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Piedmont Athens Regional Medical CenterCCN 110074 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Athens Regional7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

1295 Prince Ave
Athens, GA 30606
Phone (678) 982-4371

192 Anderson St SE
Ste 3110
Marietta, GA 30060

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
James Burnett Individual Corporate OfficerChief Executive Officer May 1, 2019
Corporate DirectorDirector May 1, 2019
Phillip E Bettendorf Individual Corporate DirectorDirector Oct 1, 2021
Samuel K Thomason Individual Corporate DirectorDirector Mar 2, 2022
Thomas Arnold Individual Operational/Managerial ControlAdministrative Cfo Piedmont Heal Oct 1, 2016
Michael J Mandl Individual Corporate DirectorDirector Mar 16, 2020
Cheryl K Legette Individual Corporate DirectorDirector Oct 1, 2016
David M Sailors Individual Corporate DirectorDirector Oct 1, 2016
Piedmont Healthcare Inc Organization, Atlanta, GA Corporation, Non-profit, Chain home office Operational/Managerial Control Oct 1, 2016 100%
Roswell Lawrence Individual Corporate DirectorDirector Mar 1, 2021
Jason Smith Individual W-2 Managing EmployeeChief Operating Officer Feb 4, 2018
Robert C Cross Individual W-2 Managing EmployeeVP-Government Reimbursement Jan 1, 2012
Operational/Managerial ControlVP Government Reimbursement Oct 1, 2016
Warren a Reddish Individual Corporate DirectorDirector Oct 1, 2017
Elizabeth H Ripps Individual Corporate DirectorDirector Mar 1, 2019
Elizabeth Leddy Individual Corporate OfficerSecretary Oct 1, 2016
Justin Webb Roberts Individual Corporate OfficerChief Financial Officer Oct 8, 2023
Carolann a Eisenhart Individual Corporate DirectorDirector Oct 1, 2019
Tony D Townley Individual Corporate DirectorDirector Mar 1, 2019
Kevin L Brown Individual Corporate DirectorDirector Oct 1, 2016

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 29

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

View all 29

Practitioners & affiliated clinicians

Practitioners 128

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 128

Affiliated clinicians 867

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

View all 867

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708905600000",
    "number": "1437186111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1199 PRINCE AVENUE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "30606",
            "telephone_number": "706-475-7000",
            "fax_number": "706-475-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 PRINCE AVENUE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "30606",
            "telephone_number": "706-475-7000",
            "fax_number": "706-475-5940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT ATHENS REGIONAL MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-27",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "GA",
            "license": "029-007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000074A",
            "state": "GA"
        }
    ],
    "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": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.