NPIMap

Organization Active NPI

Trigg County Hospital, Inc

  • Critical Access Hospital
  • Cadiz, KY
National Provider Identifier
1538218680
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
TRIGG COUNTY HOSPITAL, INC
Practice address
254 Main St
Cadiz, KY 42211-9153
Phone
(270) 522-3215
Fax
(270) 522-6974
NPI assigned
Jan 9, 2007
Last updated
Oct 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Authorized official

Name
Mr. John Sumner
Title
Ceo
Phone
(270) 522-3215

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary
Medical Physician Assistant 363AM0700X 600055 KY
Nurse Practitioner 363L00000X 600055 KY
Certified Registered Nurse Anesthetist 367500000X KY
Clinical Social Worker 1041C0700X
Pediatric Dentistry 1223P0221X
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X
Emergency Medicine Physician 207P00000X 600055 KY
Cardiovascular Disease Physician 207RC0000X
Interventional Cardiology Physician 207RI0011X
Obstetrics & Gynecology Physician 207V00000X
Otolaryngology Physician 207Y00000X
Surgery Physician 208600000X
Podiatrist 213E00000X

Addresses

Primary practice location

254 Main St
Cadiz, KY 42211-9153

Mailing address

254 Main St
Cadiz, KY 42211-9153
Phone (270) 522-3215

Other practice location 1

110 Merchant St
Cadiz, KY 42211-9797
Phone (270) 522-3215

Other identifiers 3

IdentifierTypeStateIssuer
01002724MedicaidKY
7100483490MedicaidKY
65939779MedicaidKY

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031205000118 KY Part B Supplier - Clinic/Group Practice 5193620805 Receives reassigned benefits from 105 practitioners
Practice locations: Cadiz, KY
O20080103000025 KY Part A Provider - Critical Access Hospital 5193620805 Receives reassigned benefits from 56 practitioners
Practice locations: Cadiz, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1538218680. Details of each certification follow.

Hospital certification: CCN 181304

Legal name
TRIGG COUNTY HOSPITAL, INC
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Nov 1, 2000
Last certification
May 4, 2017
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Dec 15, 1949 in KY
Enrollment address
254 Main St
Cadiz, KY 42211-9153
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Trigg County HospitalCCN 181304 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Mary James Arnp5 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.

Locations

11 Hospital St
Cadiz, KY 42211
Phone (270) 522-3441

110 Merchant St
Cadiz, KY 42211
Phone (270) 522-3215

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
Michael Gross Individual Corporate OfficerChairman of the Board Nov 1, 2007
George Radford Individual Corporate DirectorBoard Member Dec 22, 1999
Stephanie Perry Individual Corporate DirectorBoard Member Jun 2, 2008
Todd Harton Individual Corporate Officer Oct 1, 2017
Melissa Hale Individual Corporate DirectorBoard Member Sep 18, 2014
John Sumner Individual Corporate OfficerCeo May 1, 2015
W-2 Managing EmployeeCeo May 1, 2015
Christy Oliphant Individual Corporate Officer May 21, 2015
Robert Noel Individual Corporate DirectorBoard Member Nov 1, 2007
Michael Wright Individual Corporate DirectorBoard Member Oct 1, 2013
Craig Fowler Individual Corporate Officer Sep 30, 2017
Joe Nichols Individual Corporate Officer Sep 30, 2017

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 113

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 113

Affiliated clinicians 89

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

View all 89

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1538218680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 MAIN ST",
            "city": "CADIZ",
            "state": "KY",
            "postal_code": "422119153",
            "telephone_number": "270-522-3215",
            "fax_number": "270-522-6974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 MAIN ST",
            "city": "CADIZ",
            "state": "KY",
            "postal_code": "422119153",
            "telephone_number": "270-522-3215",
            "fax_number": "270-522-6974"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Merchant St",
            "address_purpose": "LOCATION",
            "city": "Cadiz",
            "state": "KY",
            "postal_code": "422119797",
            "country_code": "US",
            "telephone_number": "270-522-3215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRIGG COUNTY HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "SUMNER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "270-522-3215",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "600055",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "600055",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "600055",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01002724",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100483490",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65939779",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cadiz, KY

Sources for this page

Verify at the official NPI Registry.