NPIMap

Organization Active NPI

Taylor Regional Hospital

  • Rural Acute Care Hospital
  • Hawkinsville, GA
National Provider Identifier
1720189517
Registry record updated Jul 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
License
116175 Issued in 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
Last updated
Jul 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2025

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X 116175 GA Primary
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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720189517. Details of each certification follow.

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
CorporationNon-profit
Enrollment address
222 Perry Hwy
Hawkinsville, GA 31036-6748
Main/Primary Hospital Location
Hospital subgroups
Acute care

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 16

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

View all 16

Care Compare: Hospital

Medicare Care Compare
Listed as
Taylor Regional HospitalCCN 110256 · All quality measures
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

Locations

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

173 W Dykes St
Cochran, GA 31014
Phone (478) 934-0329

817 Griffin Ave
Eastman, GA 31023
Phone (478) 374-1801

100 Truman Rd
Hawkinsville, GA 31036

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

202 Perry Hwy
Ste 10
Hawkinsville, GA 31036

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

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

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

222 Perry Hwy
Ste 101
Hawkinsville, GA 31036

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

222 Perry Hwy
Ste 201
Hawkinsville, GA 31036

222 Perry Hwy
Ste 204
Hawkinsville, GA 31036

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

222 Perry Hwy
Ste B
Hawkinsville, GA 31036

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

1012 GA Highway 247 S
Bldg A
Kathleen, GA 31047

1012 GA Highway 247 S
Bldg A101
Kathleen, GA 31047

1012 GA Highway 247 S
Ste 101
Kathleen, GA 31047
Phone (478) 931-0776

792 1st Ave
Rochelle, GA 31079
Phone (229) 365-2248

1303 E Union St
Ste 101
Vienna, GA 31092
Phone (229) 268-1959

Ownership & related parties

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 EmployeeStaff Accountant Sep 15, 2014
Dennis Vickers Individual Corporate DirectorBoard Member - Chairman Nov 29, 1999
Donald Johnson Individual Corporate DirectorBoard Member Nov 8, 2016
John Green Individual Corporate OfficerCeo Oct 1, 2018
Joseph Ken Hardy Individual Corporate DirectorBoard Member Nov 8, 2016
Marcus Early Individual Corporate DirectorBoard Member Mar 31, 2022
William Manse Jennings Individual Corporate DirectorBoard Member - Vice-Chair Sep 8, 2016
Reuben S Roberts Individual Corporate DirectorBoard Member Jan 28, 2015
Jenna Mashburn Individual Corporate DirectorBoard Member Aug 31, 2022
Tiffany Jolly Individual Corporate OfficerCfo Sep 22, 2023
Matthew Fordham Individual Corporate DirectorBoard Member Aug 31, 2022

Owners & managing parties with NPI records 1

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

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 CenterHawkinsville, GA, CCN 115586 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 23, 2014

Owned or controlled facilities with NPI records 1

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

  • Taylor Regional Hospital

    dba Pinewood Manor Nursing Home and Rehabilitation Center

    • Skilled Nursing Facility
    • Hawkinsville, GA
    • NPI 1962800052

    5% Or Greater Direct Ownership Interest

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 27

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 27

Affiliated clinicians 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751760000000",
    "number": "1720189517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1297",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "310367297",
            "telephone_number": "478-783-0262",
            "fax_number": "478-783-2731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 PERRY HWY",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "310366748",
            "telephone_number": "478-783-0200",
            "fax_number": "478-783-2731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAYLOR REGIONAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2025-07-06",
        "certification_date": "2025-07-06",
        "status": "A",
        "authorized_official_last_name": "JOLLY",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "478-783-0200"
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "GA",
            "license": "116175",
            "primary": true
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "GA",
            "license": "116-05",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawkinsville, GA

Sources for this page

Verify at the official NPI Registry.