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Taylor Regional Hospital

Organization Active NPI Rural Acute Care Hospital · Hawkinsville, GA

NPI 1720189517 · NPPES record last updated Jul 6, 2025

Key facts

NPI
1720189517
Entity type
Organization (NPI type 2)
Primary specialty
Rural Acute Care Hospital 282NR1301X
License
116175 (GA)
Legal business name
TAYLOR REGIONAL HOSPITAL
Practice address
222 Perry Hwy
Hawkinsville, GA 31036-6748
Phone
(478) 783-0200
Fax
(478) 783-2731
NPI assigned
Sep 26, 2006
Organization subpart
No

Authorized official

Name
Tiffany Jolly
Title
Cfo
Phone
(478) 783-0200

Owners & managing parties with NPI records 1

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

Owned or controlled facilities with NPI records 1

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

Other NPIs on the same Medicare enrollment 16

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

Other NPIs with the same Medicare PAC ID 1

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

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 27

Affiliated clinicians 32

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

View all 32

Medicare Care Compare: Hospital

Listed as
Taylor Regional Hospital CCN 110256
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in GA

Hospital certification: CCN 110256

Legal name
TAYLOR REGIONAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jun 1, 2025
Last certification
Jul 1, 2024
Beds
1
Ownership / control type
Private (not for profit)
Organization structure
Corporation · Non-profit
Enrollment address
222 Perry Hwy
Hawkinsville, GA 31036-6748
Main/Primary Hospital Location
Hospital subgroups
Acute care

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Rafael Ross
Individual 		W-2 Managing Employee
Staff Accountant		 Sep 15, 2014
Dennis Vickers
Individual 		Corporate Director
Board Member - Chairman		 Nov 29, 1999
Donald Johnson
Individual 		Corporate Director
Board Member		 Nov 8, 2016
John Green
Individual 		Corporate Officer
Ceo		 Oct 1, 2018
Joseph Ken Hardy
Individual 		Corporate Director
Board Member		 Nov 8, 2016
Marcus Early
Individual 		Corporate Director
Board Member		 Mar 31, 2022
William Manse Jennings
Individual 		Corporate Director
Board Member - Vice-Chair		 Sep 8, 2016
Reuben S Roberts
Individual 		Corporate Director
Board Member		 Jan 28, 2015
Jenna Mashburn
Individual 		Corporate Director
Board Member		 Aug 31, 2022
Tiffany Jolly
Individual 		Corporate Officer
Cfo		 Sep 22, 2023
Matthew Fordham
Individual 		Corporate Director
Board Member		 Aug 31, 2022

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Pinewood Manor Nursing Home and Rehabilitation Center
Hawkinsville, GA · CCN 115586		 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 23, 2014

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040426000736 GA Part B Supplier - Clinic/Group Practice 6800795154 Receives reassigned benefits from 23 practitioners
16 other NPIs on this enrollment
Practice locations: Hawkinsville, GA; Abbeville, GA; Cochran, GA
O20250417003641 GA Part a Provider - Hospital 6800795154 Practice locations: Hawkinsville, GA

National Provider Directory

Locations

417 Broad St S
Abbeville, GA 31001
Phone (229) 467-3209

150 E Peacock St
#B
Cochran, GA 31014
Phone (478) 934-6926

145 E Peacock St
Ste 4
Cochran, GA 31014
Phone (478) 934-0008

202 Perry Hwy
Ste 104
Hawkinsville, GA 31036
Phone (478) 783-3399

222 Perry Hwy
Ste 103
Hawkinsville, GA 31036
Phone (478) 783-4080

202 Perry Hwy
Ste 102
Hawkinsville, GA 31036
Phone (478) 783-0327

222 Perry Hwy
Ste 204
Hawkinsville, GA 31036

222 Perry Hwy
Ste 104
Hawkinsville, GA 31036

222 Perry Hwy
Ste 101
Hawkinsville, GA 31036

202 Perry Hwy
Ste 10
Hawkinsville, GA 31036

222 Perry Hwy
Ste 210
Hawkinsville, GA 31036
Phone (478) 783-0200

92 Commerce St
Hawkinsville, GA 31036
Phone (478) 892-9171

100 Truman Rd
Hawkinsville, GA 31036

222 Perry Hwy
Ste B
Hawkinsville, GA 31036

135 Broad St
Ste 200
Hawkinsville, GA 31036
Phone (478) 783-0327

222 Perry Hwy
Ste 201
Hawkinsville, GA 31036

222 Perry Hwy
#104
Hawkinsville, GA 31036
Phone (478) 987-1261

1012 GA Highway 247 S
Bldg A
Kathleen, GA 31047

792 1st Ave
Rochelle, GA 31079
Phone (229) 365-7514

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X 116175 GA Yes
Ambulance 341600000X 116-05 GA

Addresses

Primary practice location

222 Perry Hwy
Hawkinsville, GA 31036-6748

Mailing address

PO Box 1297
Hawkinsville, GA 31036-7297
Phone (478) 783-0262

Other identifiers

IdentifierTypeStateIssuer
00001548AMedicaidGA

Other providers in Hawkinsville, GA

All providers in Hawkinsville, GA · Rural Acute Care Hospital in Georgia

Sources for this page

Verify at the official NPI Registry.