NPIMap

Organization Active NPI

Deaconess Union County Hospital, Inc

  • Critical Access Hospital
  • Morganfield, KY
National Provider Identifier
1497320519
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
DEACONESS UNION COUNTY HOSPITAL, INC
Practice address
4604 US Highway 60 W
Morganfield, KY 42437-6515
Phone
(270) 389-5000
NPI assigned
May 21, 2021
Last updated
Jul 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Authorized official

Name
Cheryl Annette Wathen
Title
Cfo
Phone
(812) 450-3296

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

4604 US Highway 60 W
Morganfield, KY 42437-6515

Mailing address

4604 US Highway 60 W
Morganfield, KY 42437-6515
Phone (270) 389-5000

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20211012000485 KY Part A Provider - Critical Access Hospital 5799189866 Practice locations: Morganfield, KY
O20211020001822 KY Part A Provider - Critical Access Hospital 5799189866 Practice locations: Morganfield, KY

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1497320519. Details of each certification follow.

Hospital certification: CCN 18Z306

Legal name
DEACONESS UNION COUNTY HOSPITAL, INC
Doing business as
DEACONESS UNION COUNTY HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Mar 12, 2021 in KY
Enrollment address
4604 US Highway 60 W
Morganfield, KY 42437-6515
Hospital Swing-Bed Unit

Hospital certification: CCN 181306

Legal name
DEACONESS UNION COUNTY HOSPITAL, INC
Doing business as
DEACONESS UNION COUNTY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jan 1, 2001
Last certification
Sep 25, 2001
Beds
25
Ownership / control type
Church
Organization structure
CorporationNon-profit
Incorporated
Mar 12, 2020 in KY
Enrollment address
4604 US Highway 60 W
Morganfield, KY 42437-6515
Main/Primary Hospital Location

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Methodist Hospital Union CountyCCN 181306 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Deaconess Union County Hospital Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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.

Locations

7100 Eagle Crest Blvd
Evansville, IN 47715

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
William a White Individual Corporate DirectorBoard Member Oct 1, 2021
Adam O'Nan Individual Corporate DirectorBoard Member Oct 1, 2021
Marc J Florence Individual Corporate DirectorBoard Member Oct 1, 2021
Patricia Sheffer Individual Corporate DirectorBoard Member Oct 1, 2021
Deaconess Health System Inc Organization, Evansville, IN Operational/Managerial Control Jul 1, 2020
Operational/Managerial Control Jul 1, 2020 100%
Ryan Rose Individual Corporate DirectorBoard Member Oct 1, 2021
Greg Moore Individual Corporate OfficerCfo Mar 1, 2023
W-2 Managing EmployeeCfo Mar 1, 2023
Shawn W McCoy Individual Operational/Managerial ControlCeo Oct 1, 2021
Operational/Managerial ControlChain Home Office Administrator Oct 1, 2021
Deaconess Health Kentucky Inc Organization, Evansville, IN Corporation 5% Or Greater Direct Ownership Interest Oct 1, 2021 100%
5% Or Greater Direct Ownership Interest Jul 1, 2020 100%
Tessa Gough Individual Corporate DirectorBoard Member Oct 1, 2021
Amber N Powell Individual Corporate Director Nov 1, 2025

Owners & managing parties with NPI records 4

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

Facilities with the same owner 35

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

View all 35

Practitioners & affiliated clinicians

Practitioners 31

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 31

Affiliated clinicians 120

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

View all 120

NPI Registry JSON

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626912000000",
    "number": "1497320519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4604 US HIGHWAY 60 W",
            "city": "MORGANFIELD",
            "state": "KY",
            "postal_code": "424376515",
            "telephone_number": "270-389-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4604 US HIGHWAY 60 W",
            "city": "MORGANFIELD",
            "state": "KY",
            "postal_code": "424376515",
            "telephone_number": "270-389-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEACONESS UNION COUNTY HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-21",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A",
        "authorized_official_last_name": "WATHEN",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "ANNETTE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "812-450-3296"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morganfield, KY

Sources for this page

Verify at the official NPI Registry.