NPIMap

Organization Active NPI

Coliseum Medical Center, LLC

Doing business as Piedmont Macon Medical Center

  • General Acute Care Hospital
  • Macon, GA
National Provider Identifier
1598719643
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
COLISEUM MEDICAL CENTER, LLC
Doing business as
Piedmont Macon Medical Center
Practice address
C/O Coliseum Health System
350 Hospital Drive
Macon, GA 31217
Phone
(478) 765-7000
Fax
(478) 742-1247
NPI assigned
May 22, 2006
Last updated
Feb 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Authorized official

Name
Robert C Cross
Title
VP Government Reimbursement
Phone
(470) 271-3401

Specialties & licenses 1

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

Addresses

Primary practice location

C/O Coliseum Health System
350 Hospital Drive
Macon, GA 31217

Mailing address

350 Hospital Dr
Macon, GA 31217-3838
Phone (478) 765-7000

Other identifiers 10

IdentifierTypeStateIssuer
00000459AMedicaidGA
203375OtherFLFLORIDA MEDICAID HMO
200461450AMedicaidIN
25706MedicaidMI
3522OtherGABLUE CROSS
912181100MedicaidFL
166202500OtherDEPT OF LABOR
HOS0164NMedicaidAL
1729302MedicaidLA
4103009MedicaidNJ

Other names 1

  • Piedmont Macon Medical Center Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address COLISEUM.COCCO.GAA@CCDA.HCADIRECT.NET
CONNECT URL https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service Other Ciox Health

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041109001101 GA Part A Provider - Hospital 6406819572 Practice locations: Macon, GA; Warner Robins, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1598719643. Details of each certification follow.

Hospital certification: CCN 110164

Legal name
COLISEUM MEDICAL CENTER LLC
Doing business as
PIEDMONT MACON MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Feb 11, 1971
Last certification
Jun 22, 2023
Beds
310
Ownership / control type
Private (not for profit)
Organization structure
LLCNon-profit
Enrollment address
350 Hospital Dr
Macon, GA 31217-3838
Main/Primary Hospital Location
Hospital subgroups
Acute care

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

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Coliseum Medical Centers, LLC, DbaCCN 110164 · All quality measures
Overall star rating
3 of 5
Type
Acute Care 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
Coliseum Medical Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

535 Coliseum Dr
Macon, GA 31217
Phone (478) 803-7300

Interoperability endpoints

  • Direct secure messaging: coliseum.cocco.gaa@ccda.hcadirect.net

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Thomas Arnold Individual Corporate OfficerCfo Aug 1, 2021
Michael J Mandl Individual Corporate Officer Aug 1, 2021
Piedmont Macon Hospital Inc Organization, Atlanta, GA Created for acquisition, Corporation, Holding company, Non-profit 5% Or Greater Direct Ownership Interest Aug 1, 2021 100%
Alisha R Neal Individual W-2 Managing EmployeeCfo Aug 1, 2021 100%
Piedmont Healthcare Inc Organization, Atlanta, GA Corporation, Non-profit, Chain home office Operational/Managerial Control Aug 1, 2021
Robert C Cross Individual Corporate Officer Aug 1, 2021
Elizabeth Leddy Individual Corporate Officer Aug 1, 2021

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 29

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

View all 29

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 38

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 38

Affiliated clinicians 446

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

View all 446

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": "1708905600000",
    "number": "1598719643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 HOSPITAL DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173838",
            "telephone_number": "478-765-7000",
            "fax_number": "478-742-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "C/O COLISEUM HEALTH SYSTEM",
            "address_2": "350 HOSPITAL DRIVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31217",
            "telephone_number": "478-765-7000",
            "fax_number": "478-742-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLISEUM MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VP GOVERNMENT REIMBURSEMENT",
        "authorized_official_telephone_number": "470-271-3401"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000459A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA MEDICAID HMO",
            "identifier": "203375",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200461450A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25706",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3522",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "912181100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "166202500",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HOS0164N",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1729302",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4103009",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "COLISEUM.COCCO.GAA@CCDA.HCADIRECT.NET",
            "affiliation": "N",
            "endpointDescription": "Please contact CORP.HCACEP@HCAHealthcare.com for information regarding validation steps that may be required to ensure CCDs sent to the listed direct address are successfully received",
            "address_1": "350 Hospital Dr",
            "city": "Macon",
            "state": "GA",
            "country_code": "US",
            "postal_code": "312173838",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "esmd.cioxhealth.com and OID is '2.16.840.1.113883.3.6635.1.1'",
            "affiliationName": "Ciox Health",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "925 N Point Pkwy",
            "city": "Alpharetta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300055210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Piedmont Macon Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.