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Organization Active NPI

Pikeville Medical Center Inc

  • Rehabilitation Hospital
  • Pikeville, KY
National Provider Identifier
1457433435
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
License
100366 Issued in KY
Legal business name
PIKEVILLE MEDICAL CENTER INC
Practice address
911 Bypass Rd
Pikeville, KY 41501-1689
Phone
(606) 218-3500
Fax
(606) 218-4560
NPI assigned
Oct 19, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mrs. Michelle Hagy
Title
Cfo
Phone
(606) 218-3500

Owners & managing parties with NPI records 2

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

Corporate family (same tax ID) 24

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

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

Affiliated clinicians 6

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Pikeville Medical CenterCCN 18T044
Ownership
Non-profit
Certified
Oct 1, 2003

Medicare participation

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

Hospital certification: CCN 18T044

Medicare enrollment files
Legal name
PIKEVILLE MEDICAL CENTER INC
Organization structure
CorporationNon-profit
Incorporated
Mar 16, 1923 in KY
Enrollment address
911 Bypass Rd
Building a
Pikeville, KY 41501-1689
Hospital Rehabilitation Unit
Hospital subgroups
Acute care, Rehabilitation unit

All disclosed owners & managing parties 21

Medicare enrollment files

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

NameRoleSinceShare
Melissa Thacker Individual W-2 Managing EmployeeCoo-Physician Practices Jun 15, 2015
Robert Shurtleff Individual Corporate DirectorBoard Member Mar 18, 2019
Ronald Burchett Individual Corporate DirectorBoard Member Jul 27, 1993
Tony Damron Individual W-2 Managing EmployeeChief Information Officer Oct 24, 2018
Joe Dean Anderson Individual Corporate DirectorBoard Member- Secretary/Treasurer Apr 12, 1978
David Baird Individual Corporate DirectorBoard Member Jul 24, 2018
Jyothi Mettu Individual Corporate DirectorBoard Member Jan 23, 2018
Michelle Rainey Individual W-2 Managing EmployeeChief Nursing Officer Jun 15, 2015
David Collins Individual Corporate DirectorVice Chairman Oct 27, 2010
Usda Department of Agriculture Rural Development Organization, Saint Louis, MO Financial institution 5% Or Greater Mortgage Interest Mar 20, 2013 22.26%
Julius Clinton Martin Individual Corporate DirectorBoard Member Jan 29, 2014
Kansas Justice Individual W-2 Managing EmployeeChief Operating Officer Feb 4, 2018
Aaron W Crum Individual Corporate DirectorEx-Officio Board Member Jan 23, 2018
W-2 Managing EmployeeChief Medical Officer Jan 23, 2018
Michelle Hagy Individual Corporate DirectorEx-Officio Board Member Nov 24, 2020
W-2 Managing EmployeeChief Financial Officer Oct 27, 2010
Mary Simpson Individual Corporate DirectorBoard Member Nov 1, 2007
John Labreche Individual Corporate DirectorBoard Member Nov 1, 2007
Erich Blackburn Individual Corporate DirectorEx-Officio Board Member Nov 24, 2020
W-2 Managing EmployeeChief Legal Officer Mar 15, 2018
Linda Justice Individual Corporate DirectorBoard Member Jan 22, 2019
Phillip Reed Individual Corporate DirectorBoard Member Nov 5, 2019
Christopher C Reynolds Individual Corporate DirectorBoard Member Jan 1, 2026
William Donovan Blackburn Individual Corporate DirectorBoard Chairman/Ceo Mar 18, 2019
W-2 Managing EmployeeChief Executive Officer Jan 23, 2018

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20081029000474 KY Part a Provider - Hospital 6709790157 Practice locations: Pikeville, KY

National Provider Directory

National Provider Directory
Tax ID family
Pikeville Med Center Inc (57 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X 100366 KY Primary

Addresses

NPPES NPI Registry

Primary practice location

911 Bypass Rd
Pikeville, KY 41501-1689

Mailing address

911 Bypass Rd
Pikeville, KY 41501-1689
Phone (606) 218-3500

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
93000073MedicaidKY

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 21, 2010.

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279670400000",
    "number": "1457433435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 BYPASS RD",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415011689",
            "telephone_number": "606-218-3500",
            "fax_number": "606-218-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 BYPASS RD",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415011689",
            "telephone_number": "606-218-3500",
            "fax_number": "606-218-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIKEVILLE MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2010-07-21",
        "status": "A",
        "authorized_official_last_name": "HAGY",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "606-218-3500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "KY",
            "license": "100366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "93000073",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pikeville, KY

Sources for this page

Verify at the official NPI Registry.