NPIMap

Organization Active NPI

St Elizabeth Medical Center, Inc

Doing business as St Elizabeth Hospice

  • Community Based Hospice Care Agency
  • Edgewood, KY
National Provider Identifier
1689695322
Registry record updated Dec 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
400016 Issued in KY
Legal business name
ST ELIZABETH MEDICAL CENTER, INC
Doing business as
St Elizabeth Hospice
Practice address
483 South Loop Rd
Edgewood, KY 41017
Phone
(859) 301-4600
Fax
(859) 655-1773
NPI assigned
Jul 21, 2006
Last updated
Dec 4, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2014

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

Authorized official

Name
Lori Ritchey-Baldwin
Title
Cfo (Interim)
Phone
(859) 655-0109

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 400016 KY Primary

Addresses

Primary practice location

483 South Loop Rd
Edgewood, KY 41017

Mailing address

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 655-1889

Other identifiers 1

IdentifierTypeStateIssuer
44059012MedicaidKY

Other names 1

  • St Elizabeth Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080723000013 KY Part A Provider - Hospice 0648174623 Practice locations: Edgewood, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689695322. Details of each certification follow.

Hospice certification: CCN 181513

Legal name
ST ELIZABETH MEDICAL CENTER, INC
Doing business as
ST ELIZABETH HEALTHCARE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Feb 25, 1988
Last certification
Dec 21, 2005
Ownership / control type
Non-Profit - Church
Organization structure
CorporationNon-profit
Incorporated
Apr 3, 1978 in KY
Enrollment address
483 S Loop Rd
Edgewood, KY 41017-5446

Other NPIs with the same Medicare PAC ID 14

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

View all 14

Care Compare: Hospice

Medicare Care Compare
Listed as
Hospice Care of St Elizabeth HealthcareCCN 181513 · All quality measures
Ownership
Non-Profit
Certified
Feb 25, 1988
Medicare certification status
ActiveFrom the Provider of Services file

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
18D1070824Hospice Care of St Elizabeth Medical Center483 South Loop Drive, Edgewood, KY 41017Certificate of waiverJul 9, 2027

National Provider Directory

National Provider Directory
Tax ID family
St Elizabeth Grant Coun26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

Locations

483 S Loop Rd
Edgewood, KY 41017
Phone (859) 301-4600

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Donald L Price Individual Corporate DirectorBoard Member Jan 1, 2024
Robert D Moorhead Individual Corporate DirectorBoard Member Jan 1, 2021
Jason Jackman Individual Corporate DirectorBoard Member Jan 1, 2019
Jackie S Sweeney Individual Corporate DirectorBoard Member Jan 1, 2019
Sylvia Buxton Individual Corporate DirectorBoard Member Jan 1, 2024
Joseph Koester Individual Corporate DirectorBoard Member Jan 1, 2020
Lori a Ritchey-Baldwin Individual Corporate OfficerCorporate Treasurer - Cfo Jan 1, 2014
W-2 Managing EmployeeCorporate Treasurer - Cfo Jan 1, 2014
John Hawkins Individual Corporate DirectorBoard Member Jan 1, 2023
Robert Stevens Individual Corporate DirectorBoard Member Jan 1, 2022
Kristi Nelson Individual Corporate DirectorBoard Member Jan 1, 2022
Andrew Schaeffer Individual Corporate DirectorBoard Member Jan 1, 2019
Jeanne Schroer Individual Corporate DirectorBoard Member Jan 1, 2023
Debbie Simpson Individual Corporate DirectorBoard Member Jan 1, 2026
Kris Knochelmann Individual Corporate DirectorBoard Member Jan 1, 2021
Garren Colvin Individual Corporate OfficerPresident and Ceo Nov 16, 2007
Corporate DirectorPresident and Ceo Feb 13, 2015
W-2 Managing EmployeePresident and Ceo Nov 16, 2007
Marsha a Ladenburger Individual Corporate DirectorBoard Member Jan 1, 2021
Derek Haught Individual Corporate DirectorBoard Member Jan 1, 2025
Lisa Frey Individual Corporate OfficerCorporate Secretary Jan 1, 2019
Vera Hall Individual Corporate OfficerVice President Jan 1, 2024
W-2 Managing EmployeeVice President Jan 1, 2024

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St. Elizabeth Dearborn HospitalLawrenceburg, IN, CCN 150086 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2020
St. Elizabeth Ft. Thomas - SNFFort Thomas, KY, CCN 185328 Skilled nursing facility Adp of the SNF Dec 31, 2024
St Elizabeth HealthcareEdgewood, KY, CCN 185394 Skilled nursing facility Adp of the SNF Jan 16, 2019
St. Elizabeth Home CareFlorence, KY, CCN 187075 Home health agency 5% Or Greater Direct Ownership Interest (50%) Dec 3, 2007
St Elizabeth Home Care ServicesLawrenceburg, IN, CCN 157055 Home health agency 5% Or Greater Direct Ownership Interest (50%) Oct 9, 2020

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Affiliated clinicians 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417651200000",
    "number": "1689695322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173403",
            "telephone_number": "859-655-1889",
            "fax_number": "859-578-5980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 SOUTH LOOP RD",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "41017",
            "telephone_number": "859-301-4600",
            "fax_number": "859-655-1773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ELIZABETH MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2014-12-04",
        "status": "A",
        "authorized_official_last_name": "RITCHEY-BALDWIN",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "CFO (INTERIM)",
        "authorized_official_telephone_number": "859-655-0109"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "KY",
            "license": "400016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44059012",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Elizabeth Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.