NPIMap

Organization Active NPI

Saint Joseph Health System, Inc.

Doing business as London Pediatric & Adolescent Medicine

  • Rural Health Clinic/Center
  • London, KY
National Provider Identifier
1508918533
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
900090 Issued in KY
Legal business name
SAINT JOSEPH HEALTH SYSTEM, INC.
Doing business as
London Pediatric & Adolescent Medicine
Practice address
378 Thompson Poynter Rd
London, KY 40741-7238
Phone
(606) 877-3990
Fax
(606) 877-3993
NPI assigned
Jan 18, 2007
Last updated
Jan 25, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
SAINT JOSEPH HEALTH SYSTEM, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Authorized official

Name
Christy Spitser
Title
VP of Finance
Phone
(859) 313-1694

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 900090 KY Primary

Addresses

Primary practice location

378 Thompson Poynter Rd
London, KY 40741-7238

Mailing address

PO Box 936
London, KY 40743-0936
Phone (606) 330-7835

Other names 1

  • London Pediatric & Adolescent Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100429000282 KY Part A Provider - Rural Health Clinic 4183641400 Practice locations: London, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508918533. Details of each certification follow.

Rural health clinic certification: CCN 183435

Legal name
SAINT JOSEPH HEALTH SYSTEM INC
Doing business as
LONDON PEDIATRIC AND ADOLESCENT MEDICINE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 30, 1997
Last certification
Oct 2, 2017
Ownership / control type
2B
Most recent change of ownership
Jul 1, 2008 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Sep 30, 1998 in KY
Enrollment address
378 Thompson Poynter Rd
London, KY 40741-7238
Related CCNs
180011

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

Other NPIs with the same Medicare PAC ID 14

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

View all 14

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D0893094London Pediatric & Adolescent Medicine378 Thompson Poynter Road, London, KY 40741Provider-performed microscopyApr 23, 2027

National Provider Directory

National Provider Directory
Tax ID family
Saint Joseph Home Health Services24 organizations share this tax ID, including this one
Part of
Saint Joseph Home Health Services

Other organizations with this tax ID 23

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

View all 23

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Tracey Gilbert Individual W-2 Managing EmployeeAd; Dec 1, 2022
Commonspirit Health Organization, Chicago, IL Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Jan 1, 2012 100%
Adeline Fehribach Individual Corporate Officer Jul 1, 2021
Matthew Brown Individual Corporate OfficerPresident Jul 1, 2025
Corporate DirectorBoard Member Jul 1, 2025
Jane J Chiles Individual Corporate DirectorBoard Member Sep 1, 2013
Matthew L Grimshaw Individual Corporate DirectorAdvisory Board Member (Ex Officio) Jul 1, 2025
Kentuckyone Health Inc Organization, Lexington, KY Corporation, Non-profit 5% Or Greater Direct Ownership Interest Sep 1, 2013 100%
Terika Richardson Mbanu Individual Corporate DirectorBoard Member Jul 1, 2025
Donald D Hearne Individual Corporate OfficerSecretary Jul 1, 2025
Mary-Alicha Weldon Individual Corporate Director Jul 1, 2020
Thomas Kopfensteiner Individual Corporate DirectorBoard Member Jul 1, 2025
Christy L Spitser Individual W-2 Managing EmployeeVP of Finance Mar 1, 2014
Daniel C Rodrigue Individual Corporate Director Jul 1, 2021
Emmanuel C Yumang Individual Corporate Officer Jul 1, 2024
Martha Jones Individual Corporate DirectorAdvisory Board Member Jul 1, 2025
Monica Kennison Individual Corporate Officer Jul 1, 2024
Granetta Blevins Individual Corporate Officer Jul 1, 2022
Winston Griffin Individual Corporate Officer Jul 1, 2021
Melissa Moore Murphy Individual Corporate Officer Jul 1, 2021
Daryl Love Individual Corporate Officer Jul 1, 2024
Kim Potter-Blair Individual Corporate Officer Jul 1, 2021

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Continuing Care Hospital IncLexington, KY, CCN 182002 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 30, 1998
CHI Saint Joseph BereaBerea, KY, CCN 181329 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2012
CHI Saint Joseph LondonLondon, KY, CCN 180011 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2008
CHI Saint Joseph Berea NFBerea, KY, CCN 18Z329 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2012

Owned or controlled facilities with NPI records 5

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

Facilities with the same owner 12

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

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1508918533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407430936",
            "telephone_number": "606-330-7835",
            "fax_number": "606-330-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "378 THOMPSON POYNTER RD",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407417238",
            "telephone_number": "606-877-3990",
            "fax_number": "606-877-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT JOSEPH HEALTH SYSTEM, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAINT JOSEPH HEALTH SYSTEM, INC.",
        "enumeration_date": "2007-01-18",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "SPITSER",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "859-313-1694"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "KY",
            "license": "900090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "London Pediatric & Adolescent Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "London Pediatric & Adolescent Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in London, KY

Sources for this page

Verify at the official NPI Registry.