NPIMap

Organization Active NPI

T J Samson Community Hospital

Doing business as T J Health Cave City

  • Rural Health Clinic/Center
  • Cave City, KY
National Provider Identifier
1629429360
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
T J SAMSON COMMUNITY HOSPITAL
Doing business as
T J Health Cave City
Practice address
440 E Happy Valley St
Cave City, KY 42127-8844
Phone
(270) 773-2111
Fax
(270) 773-2117
NPI assigned
Jun 23, 2016
Last updated
Mar 30, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
T J REGIONAL HEALTH INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Authorized official

Name
Neil Thornbury
Title
Ceo
Phone
(270) 651-4159

Specialties & licenses 1

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

Addresses

Primary practice location

440 E Happy Valley St
Cave City, KY 42127-8844

Mailing address

PO Box 645996
Cincinnati, OH 45264-5996
Phone (270) 651-4444

Other identifiers 1

IdentifierTypeStateIssuer
7100466600MedicaidKY

Other names 1

  • T J Health Cave City Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160912001182 KY Part A Provider - Rural Health Clinic 0648182600 Practice locations: Cave City, KY
O20161005001505 KY Part B Supplier - Clinic/Group Practice 0648182600 Receives reassigned benefits from 17 practitioners
Practice locations: Glasgow, KY; Cave City, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629429360. Details of each certification follow.

Rural health clinic certification: CCN 183493

Legal name
T J SAMSON COMMUNITY HOSPITAL
Doing business as
T J HEALTH CAVE CITY
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 2, 2016
Last certification
Nov 2, 2016
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Sep 6, 1978 in KY
Enrollment address
440 E Happy Valley St
Cave City, KY 42127-8844
Related CCNs
180017

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

Other NPIs with the same Medicare PAC ID 7

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

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
18D2115275T J Health Cave City Clinic440 East Happy Valley Road, Cave City, KY 42127Certificate of waiverSep 3, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
Thomas Rich Alexander Individual Corporate DirectorBoard Member Aug 1, 2016
Ladonna G Rogers Individual Corporate OfficerEvp / Human Resources Jan 1, 2021
Stacey Biggs Individual Corporate OfficerEvp / Marketing Jan 1, 2021
Neil C Thornbury Individual Corporate OfficerCeo Jan 1, 2021
W-2 Managing EmployeeCeo Jan 1, 2021
Jodie Holgate Individual Corporate OfficerEvp / Patient Care Services Jan 1, 2021
Bo Matthews Individual Corporate DirectorBoard Member Jan 1, 2021
TJ Regional Health Inc Organization, Glasgow, KY Non-profit Operational/Managerial Control Aug 1, 2016
Ervin Sorrell Individual Corporate DirectorBoard Member Jan 1, 2021
Michael S Young Individual Corporate DirectorBoard Member Aug 1, 2016
Brent Billingsley Individual Corporate DirectorBoard Member Jan 1, 2020
Brandon Dickey Individual Corporate OfficerEvp / Cno Jan 1, 2021
James Lee Individual Corporate OfficerEvp / Support Services Jan 1, 2021
Mei Deng Individual Corporate OfficerCfo Jan 1, 2021
Christy Biggerstaff Individual W-2 Managing EmployeeBusiness Office Director Jan 1, 2021
Cornelius Faulkner Individual Corporate DirectorBoard Member May 1, 2022
Amy N Norris-Cassady Individual Corporate DirectorBoard Member May 1, 2022
Michael Andrew Saridakis Individual Corporate DirectorBoard Member Jan 1, 2022
Daniel Foutch Individual Corporate DirectorBoard Member Aug 1, 2016
Jennifer Cerwinske Individual Corporate OfficerEvp / Practice Mangement Jan 1, 2021
Joseph Botts Individual Corporate DirectorBoard Member Aug 1, 2016
Henry Royse Individual Corporate DirectorBoard Member Aug 1, 2016
Kylend Hollie Kiser Individual Corporate DirectorBoard Member Jan 1, 2022

Owners & managing parties with NPI records 3

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

Facilities with the same owner 12

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

Practitioners & affiliated clinicians

Practitioners 147

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 147

NPI Registry JSON

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1629429360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 645996",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452645996",
            "telephone_number": "270-651-4444",
            "fax_number": "270-651-4892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 E HAPPY VALLEY ST",
            "city": "CAVE CITY",
            "state": "KY",
            "postal_code": "421278844",
            "telephone_number": "270-773-2111",
            "fax_number": "270-773-2117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T J SAMSON COMMUNITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "T J REGIONAL HEALTH INC",
        "enumeration_date": "2016-06-23",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "THORNBURY",
        "authorized_official_first_name": "NEIL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "270-651-4159"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100466600",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "T J Health Cave City",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "T J Health Cave City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cave City, KY

Sources for this page

Verify at the official NPI Registry.