NPIMap

Organization Active NPI

Premier Healthcare Investments

Doing business as Flint River Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Montezuma, GA
National Provider Identifier
1588093637
Registry record updated Aug 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
PREMIER HEALTHCARE INVESTMENTS
Doing business as
Flint River Hospital
Practice address
509 Sumter
Montezuma, GA 31063
Phone
(478) 472-3100
Fax
(478) 472-3248
NPI assigned
Nov 8, 2013
Last updated
Aug 5, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2015

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

Authorized official

Name
John Hopfensperger
Title
President
Phone
(920) 621-6140

Specialties & licenses 1

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

Addresses

Primary practice location

509 Sumter
Montezuma, GA 31063

Mailing address

PO Box 538579
Atlanta, GA 30353-8579
Phone (478) 472-3100

Other names 1

  • Flint River Hospital Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140424000879 GA Part A Provider - Hospital 9830327972 Practice locations: Montezuma, GA
O20141219001548 GA Part B Supplier - Clinic/Group Practice 9830327972 Receives reassigned benefits from 13 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Montezuma, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1588093637. Details of each certification follow.

Hospital certification: CCN 11U190

Legal name
PREMIER HEALTHCARE INVESTMENTS
Doing business as
FLINT RIVER COMMUNITY HOSPITAL
Organization structure
LLCProprietary
Incorporated
Apr 12, 2013 in DE
Enrollment address
509 Sumter St
Montezuma, GA 31063-1733
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).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Premier Healthcare Inv4 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.

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Daniel Pincus Revocable Trust Organization, Hilton Head, SC 5% Or Greater Indirect Ownership Interest Feb 25, 2014 5.98%
Premier Healthcare Investments Managing Member, LLC Organization, Brentwood, TN For-profit 5% Or Greater Indirect Ownership Interest Feb 25, 2014 50%
The Southern Baptist Theological Seminary #902 Organization, Louisville, KY Non-profit 5% Or Greater Indirect Ownership Interest Feb 25, 2014 31.1%
Macon County Healthcare Investors, LLC Organization, Montezuma, GA For-profit 5% Or Greater Direct Ownership Interest Feb 25, 2014 100%
Baptist Gardens Organization, Long Beach, CA Non-profit 5% Or Greater Indirect Ownership Interest Feb 25, 2014 11.98%
John J Hopfensperger Individual Corporate Officer Feb 25, 2014
W-2 Managing Employee Feb 25, 2014

Facilities with the same owner 3

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

  • Premier Healthcare Investments

    dba Flint River Hospital

    • General Acute Care Hospital
    • Montezuma, GA
    • NPI 1528497351

    Baptist Gardens, Daniel Pincus Revocable Trust, Macon County Healthcare Investors, LLC, Premier Healthcare Investments Managing Member, LLC, The Southern Baptist Theological Seminary #902

    CMS ownership
  • Premier Healthcare Investments

    dba Flint River Rural Health Clinic - Oglethorpe

    • Rural Health Clinic/Center
    • Montezuma, GA
    • NPI 1659700763

    Baptist Gardens, Daniel Pincus Revocable Trust, Macon County Healthcare Investors, LLC, Premier Healthcare Investments Managing Member, LLC, The Southern Baptist Theological Seminary #902

    CMS ownership
  • Premier Healthcare Investments

    dba Riverside Treatment Center, Flint River Hospital

    • Psychiatric Hospital Unit
    • Montezuma, GA
    • NPI 1740619857

    Baptist Gardens, Daniel Pincus Revocable Trust, Macon County Healthcare Investors, LLC, Premier Healthcare Investments Managing Member, LLC, The Southern Baptist Theological Seminary #902

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438732800000",
    "number": "1588093637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 538579",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303538579",
            "telephone_number": "478-472-3100",
            "fax_number": "478-472-3248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 SUMTER",
            "city": "MONTEZUMA",
            "state": "GA",
            "postal_code": "31063",
            "telephone_number": "478-472-3100",
            "fax_number": "478-472-3248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER HEALTHCARE INVESTMENTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-08",
        "last_updated": "2015-08-05",
        "status": "A",
        "authorized_official_last_name": "HOPFENSPERGER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-621-6140"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Flint River Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montezuma, GA

Sources for this page

Verify at the official NPI Registry.