Gadsden Community Hospital

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

4369 Issued in FL

Legal business name

GADSDEN COMMUNITY HOSPITAL

Practice address

23186 Blue Star Highway
Quincy, FL 32351

Phone

(850) 926-4160

Fax

(850) 926-0254

NPI assigned

Feb 15, 2007

Last updated

Jun 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Joe Sharp

Title

Consultant

Phone

(850) 926-4160

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Gadsden Hospital Inc Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1619010923. Details of each certification follow.

• CCN 101306 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 101306

Legal name

GADSDEN COMMUNITY HOSPITAL

Certification status

Terminated Involuntary: failure to meet health/safety requirements, Nov 27, 2005

Provider type (POS)

Hospital – Critical access hospital

Participating since

Jun 5, 2001

Last certification

Nov 4, 2005

Beds

25

Ownership / control type

Other

Facility address

23186 Blue Star Hwy
Quincy, FL 32351

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1619010923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 SAND PINE TRL",
            "city": "CRAWFORDVILLE",
            "state": "FL",
            "postal_code": "323271247",
            "telephone_number": "850-926-4160",
            "fax_number": "850-926-0254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23186 BLUE STAR HIGHWAY",
            "city": "QUINCY",
            "state": "FL",
            "postal_code": "32351",
            "telephone_number": "850-926-4160",
            "fax_number": "850-926-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GADSDEN COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "SHARP",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "CONSULTANT",
        "authorized_official_telephone_number": "850-926-4160",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "FL",
            "license": "4369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10081100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HL100159",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gadsden Hospital Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Caron A Forehand, OWNER
• Fresh Start Health Care Services,Inc
• James A Fullerton, PTA
• Taylor C Fultineer
• Keisey Fumero
• Gadsden County Head Start Program
• Gadsden County Health Department
• Gadsden County School Board
• Gadsden County School Board
• Gadsden County School Board

• General Acute Care Hospital in Quincy, FL
• Providers in Quincy, FL by specialty
• General Acute Care Hospital in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.