NPIMap

Organization Active NPI

Redmond Park Hospital, LLC

Doing business as Adventhealth Redmond

  • General Acute Care Hospital
  • Rome, GA
National Provider Identifier
1508810565
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
REDMOND PARK HOSPITAL, LLC
Doing business as
Adventhealth Redmond
Redmond Regional Medical Center
Practice address
501 Redmond Rd NW
Rome, GA 30165-1415
Phone
(706) 291-0291
Fax
(706) 291-0971
NPI assigned
May 22, 2006
Last updated
Mar 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Authorized official

Name
Jeffrey Prusia
Title
Cfo
Phone
(706) 802-3035

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

501 Redmond Rd NW
Rome, GA 30165-1415

Mailing address

501 Redmond Rd NW
Rome, GA 30165-1415
Phone (706) 291-0291

Other identifiers 8

IdentifierTypeStateIssuer
0110168MedicaidTN
00001581AMedicaidGA
902540500MedicaidFL
100069OtherGABLUE CROSS
156120400OtherDEPT OF LABOR
7153OtherTNBLUECARE
200044050AMedicaidOK
HOS0168PMedicaidAL

Other names 2

  • ADVENTHEALTH REDMOND Doing business as
  • REDMOND REGIONAL MEDICAL CENTER Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://www.mettles.com/ Other
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other CMS HIH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040823000769 GA Part A Provider - Hospital 0244216570 Practice locations: Cedartown, GA; Rome, GA
O20250224001215 GA Part B Supplier - Intensive Cardiac Rehabilitation 0244216570 Practice locations: Rome, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508810565. Details of each certification follow.

Hospital certification: CCN 110168

Legal name
REDMOND PARK HOSPITAL LLC
Doing business as
ADVENTHEALTH REDMOND
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 4, 1972
Last certification
Jan 23, 2024
Beds
201
Ownership / control type
Private (for profit)
Organization structure
LLCNon-profit
Incorporated
Jul 1, 2004 in GA
Enrollment address
501 Redmond Rd NW
Rome, GA 30165-1415
Main/Primary Hospital Location
Hospital subgroups
Acute care, Rehabilitation unit

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).

Care Compare: Hospital

Medicare Care Compare
Listed as
Adventhealth RedmondCCN 110168 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Redmond Park Hospital LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1168 N Main St
Cedartown, GA 30125
Phone (770) 749-1005

1168 N Main St
Ste 100
Cedartown, GA 30125
Phone (770) 749-8561

100 John Maddox Dr NW
Ste 110
Rome, GA 30165
Phone (706) 802-3852

2112 Shorter Ave NW
Ste 210
Rome, GA 30165
Phone (706) 236-1911

591 Redmond Rd NW
Ste 103
Rome, GA 30165
Phone (706) 368-8500

591 Redmond Rd NW
Ste 203
Rome, GA 30165
Phone (706) 528-9060

610 Shorter Ave NW
Ste 20
Rome, GA 30165
Phone (706) 236-1911

216 Central Ave
Trion, GA 30753
Phone (706) 734-3003

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
Alan Guyton, Jr Individual Corporate OfficerSecretary Apr 7, 2021
Corporate DirectorManager Oct 22, 2021
Gary Rustad Individual Corporate DirectorManager Oct 21, 2021
Diane Godfrey Individual Corporate OfficerAssistant Secretary Dec 11, 2025
Karsten Randolph Individual Corporate DirectorManager Oct 22, 2021
Isaac Sendros Individual Contracted Managing EmployeeChief Executive Officer Feb 27, 2023
Corporate OfficerPresident Feb 27, 2023
Corporate DirectorDirector Feb 27, 2023
Operational/Managerial ControlChief Executive Officer Feb 27, 2023
Michael Saunders Individual Corporate OfficerAssistant Secretary Oct 1, 2021
Audrey E. Gregory Individual Corporate DirectorManager Aug 21, 2025
Michael J Thompson Individual Corporate OfficerChairperson Jan 29, 2023
Corporate DirectorDirector Jan 29, 2023
Adventist Health System Sunbelt Healthcare Corporation Organization, Altamonte Springs, FL Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Oct 2, 2021 100%
Ryan P Stanger Individual Corporate DirectorDirector Aug 22, 2024
Haney Vincent Individual Corporate OfficerAssistant Secretary Apr 7, 2021
Dixon L Freeman Individual Corporate DirectorDirector Aug 22, 2024
Jeffrey Prusia Individual Contracted Managing EmployeeChief Financial Officer May 22, 2023
Corporate OfficerTreasurer May 22, 2023
Operational/Managerial ControlChief Financial Officer May 22, 2023
Lynn Addiscott Individual Corporate OfficerAssistant Secretary Oct 1, 2021
Cecil B Wright Individual Corporate DirectorDirector Aug 22, 2024
Beverly Morgan Individual Corporate OfficerAssistant Secretary Aug 21, 2025

Owners & managing parties with NPI records 1

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

Facilities with the same owner 85

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

View all 85

Practitioners & affiliated clinicians

Practitioners 40

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 40

Affiliated clinicians 411

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

View all 411

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1508810565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 REDMOND RD NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651415",
            "telephone_number": "706-291-0291",
            "fax_number": "706-291-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 REDMOND RD NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651415",
            "telephone_number": "706-291-0291",
            "fax_number": "706-291-0971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDMOND PARK HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "PRUSIA",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "706-802-3035"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0110168",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00001581A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "902540500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "100069",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "156120400",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECARE",
            "identifier": "7153",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200044050A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HOS0168P",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com/",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "CMS HIH",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "7500 Security Blvd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212441849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ADVENTHEALTH REDMOND",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "REDMOND REGIONAL MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "REDMOND REGIONAL MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.