NPIMap

Organization Active NPI

Smyth County Community Hospital

Doing business as Smyth County Community Hospital Swing Bed Unit

  • Medicare Defined Swing Bed Hospital Unit
  • Marion, VA
National Provider Identifier
1487832200
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
SMYTH COUNTY COMMUNITY HOSPITAL
Doing business as
Smyth County Community Hospital Swing Bed Unit
Practice address
245 Medical Park Dr
Marion, VA 24354-1100
Phone
(276) 378-1000
Fax
(276) 378-1845
NPI assigned
Feb 4, 2008
Last updated
Apr 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Authorized official

Name
Shane Edwin Hilton
Title
Evp/Cfo
Phone
(423) 302-3467

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

Addresses

Primary practice location

245 Medical Park Dr
Marion, VA 24354-1100

Mailing address

311 Princeton Rd Ste 1
Johnson City, TN 37601-2026
Phone (276) 378-1000

Other names 1

  • Smyth County Community Hospital Swing Bed Unit Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://67.32.31.88:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other Smyth County Community Hospital

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080214000532 VA Part A Provider - Hospital 0446168496 Practice locations: Marion, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487832200. Details of each certification follow.

Hospital certification: CCN 49U038

Legal name
SMYTH COUNTY COMMUNITY HOSPITAL
Doing business as
SMYTH COUNTY SWING BED UNIT
Organization structure
CorporationNon-profit
Incorporated
Dec 12, 1961 in VA
Enrollment address
245 Medical Park Drive
Marion, VA 24354-6587
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 3

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

National Provider Directory

National Provider Directory
Tax ID family
SCCH Ta Phys Care of SGRP5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Shane Hilton Individual Corporate OfficerEvp.Cfo Apr 4, 2024
Corporate DirectorEvp/Cfo Apr 4, 2024
Gregory Wilgocki Individual Corporate DirectorSVP Feb 1, 2018
W-2 Managing EmployeeSVP Feb 1, 2018
Ballad Health Organization, Johnson City, TN Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Feb 1, 2018 100%
Marvin Eichorn Individual Corporate OfficerEvp/Cao Feb 1, 2018
Corporate DirectorBoard Member Feb 1, 2018
Mountain States Health Alliance Organization, Johnson City, TN Corporation, Non-profit 5% Or Greater Direct Ownership Interest Nov 10, 2021 100%
Buford Deaton Individual Corporate OfficerEvp/Coo Feb 1, 2018
Corporate DirectorBoard Member Feb 1, 2018
Alan Levine Individual Corporate OfficerCeo/President Feb 1, 2018
Corporate DirectorBoard Member Feb 1, 2018
Julie Bennett Individual Corporate OfficerEvp/Clo Feb 1, 2023
Corporate DirectorBoard Member Feb 1, 2023

Owners & managing parties with NPI records 21

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

View all 21

Facilities with the same owner 41

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

View all 41

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1202083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713225600000",
    "number": "1487832200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 PRINCETON RD STE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012026",
            "telephone_number": "276-378-1000",
            "fax_number": "276-378-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 MEDICAL PARK DR",
            "city": "MARION",
            "state": "VA",
            "postal_code": "243541100",
            "telephone_number": "276-378-1000",
            "fax_number": "276-378-1845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMYTH COUNTY COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-04",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A",
        "authorized_official_last_name": "HILTON",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "EVP/CFO",
        "authorized_official_telephone_number": "423-302-3467"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://67.32.31.88:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1340.1",
            "affiliationName": "Smyth County Community Hospital",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "1.5, 1.6",
            "address_1": "245 Medical Park Dr",
            "city": "Marion",
            "state": "VA",
            "country_code": "US",
            "postal_code": "243541100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Smyth County Community Hospital Swing Bed Unit",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Smyth County Community Hospital Swing Bed Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marion, VA

Sources for this page

Verify at the official NPI Registry.