NPIMap

Organization Active NPI

University McDuffie County Regional Medical Center, Inc

Doing business as Piedmont McDuffie Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Thomson, GA
National Provider Identifier
1437536372
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER, INC
Doing business as
Piedmont McDuffie Hospital
University Hospital McDuffie--Swingbed Unit
Practice address
2460 Washington Road NE
Thomson, GA 30824-2199
Phone
(706) 595-1411
Fax
(706) 597-5139
NPI assigned
Apr 29, 2015
Last updated
Mar 2, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
MCDUFFIE COUNTY REGIONAL MEDICAL CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

Addresses

Primary practice location

2460 Washington Road NE
Thomson, GA 30824-2199

Mailing address

2460 Washington Road NE
Thomson, GA 30824-2199
Phone (706) 595-1411

Other identifiers 2

IdentifierTypeStateIssuer
00001185MedicaidGA
11-0111OtherPARENT MEDICARE CCN

Other names 2

  • Piedmont McDuffie Hospital Doing business as
  • University Hospital McDuffie--Swingbed Unit Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160805001299 GA Part A Provider - Hospital 4183873672 Practice locations: Thomson, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1437536372. Details of each certification follow.

Hospital certification: CCN 11U111

Legal name
UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER, INC.
Doing business as
PIEDMONT MCDUFFIE HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Dec 30, 2011 in GA
Enrollment address
2460 Washington Rd
Thomson, GA 30824-6600
Hospital Swing-Bed Unit
Hospital subgroups
Swing-bed approved

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

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Univ McDuffie Ctr2 organizations share this tax ID, including this one
Part of
Univ McDuffie Ctr

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
University Health, Inc Organization, Augusta, GA Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2012
David a Belkoski Individual Corporate OfficerPag Cfo Jul 1, 2012
W-2 Managing EmployeePag Cfo Jul 1, 2012
Thomas Arnold Individual Corporate OfficerCfo PHC Mar 1, 2022
Joe Terrell Wills Individual Corporate DirectorBoard Member Jul 1, 2012
Charles L Brown Individual Corporate DirectorCeo Piedmont Physicians Mar 1, 2022
James Davis Individual Corporate OfficerPresident Jul 1, 2012
Corporate DirectorBoard Member Jul 1, 2012
Edward Burr Individual Corporate OfficerSecretary Jul 1, 2012
Corporate DirectorBoard Member Jul 1, 2012
Piedmont Healthcare Inc Organization, Atlanta, GA Corporation, Non-profit, Chain home office Operational/Managerial Control Mar 1, 2022
John B Bieltz Individual Corporate DirectorBoard Member Jan 1, 2016
University McDuffie County Regional Medical Center, Inc. Organization, Thomson, GA Operational/Managerial Control Jul 1, 2012
Robert C Cross Individual Corporate OfficerVP Gov'T Reimbursement Mar 1, 2022
Robert J Kepshire Individual Corporate OfficerAdministrator/Cno Jan 1, 2016
W-2 Managing EmployeeAdministrator/Cno Jan 1, 2016
Robin Dudley Individual Corporate DirectorBoard Member Jul 1, 2012
William Doupe' Individual Corporate DirectorBoard Member Jul 1, 2012
Marilyn a Bowcutt Individual Corporate OfficerPresident Jan 1, 2016
W-2 Managing Employee Jan 1, 2016
Kevin L Brown Individual Corporate DirectorPresident/Ceo PHC Mar 1, 2022

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Piedmont McDuffie HospitalThomson, GA, CCN 110111 Hospital Operational/Managerial Control Jul 1, 2012

Owned or controlled facilities with NPI records 1

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

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

Affiliated clinicians 3

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": "1430265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1437536372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 WASHINGTON ROAD NE",
            "city": "THOMSON",
            "state": "GA",
            "postal_code": "308242199",
            "telephone_number": "706-595-1411",
            "fax_number": "706-597-5139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 WASHINGTON ROAD NE",
            "city": "THOMSON",
            "state": "GA",
            "postal_code": "308242199",
            "telephone_number": "706-595-1411",
            "fax_number": "706-597-5139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MCDUFFIE COUNTY REGIONAL MEDICAL CENTER, INC",
        "enumeration_date": "2015-04-29",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "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": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00001185",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARENT  MEDICARE CCN",
            "identifier": "11-0111",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Piedmont McDuffie Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University Hospital McDuffie--Swingbed Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Thomson, GA

Sources for this page

Verify at the official NPI Registry.