NPIMap

Organization Active NPI

Landmark Hospital of Athens, LLC

  • Long Term Care Hospital
  • Athens, GA
National Provider Identifier
1740452820
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
License
APPLIED FOR
Legal business name
LANDMARK HOSPITAL OF ATHENS, LLC
Practice address
775 Sunset Drive
Athens, GA 30606
Phone
(573) 335-1091
NPI assigned
Mar 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Authorized official

Name
Tracy Lynne Bollinger, CPA
Title
Cfo
Phone
(573) 450-2530

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X APPLIED FOR Primary

Addresses

Primary practice location

775 Sunset Drive
Athens, GA 30606

Mailing address

PO Box 267
Jackson, MO 63755-0267
Phone (573) 331-8412

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090304000634 GA Part A Provider - Hospital 1153491006 Practice locations: Athens, GA
O20130116000171 GA Part B Supplier - Clinic/Group Practice 1153491006 Receives reassigned benefits from 6 practitioners
Practice locations: Athens, GA

Hospital certification: CCN 112017

Legal name
LANDMARK HOSPITAL OF ATHENS, LLC
Certification status
Active
Provider type (POS)
Hospital – Long-term
Participating since
Feb 1, 2009
Last certification
Oct 25, 2024
Beds
42
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Sep 26, 2006 in GA
Enrollment address
775 Sunset Dr
Athens, GA 30606-2211
Other Hospital Practice Location
Hospital subgroups
General, Acute care, Other

Hospital certification: CCN 110231

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
LANDMARK HOSPITAL OF ATHENS, LLC
Certification status
Terminated Other: provider status change, Jan 31, 2009
Provider type (POS)
Hospital – Short-term
Participating since
Jul 21, 2008
Last certification
Jul 21, 2008
Beds
42
Ownership / control type
Private (for profit)
Facility address
775 Sunset Drive
Athens, GA 30606

Care Compare: Long-term care hospital

Medicare Care Compare
Listed as
Landmark Hospital of Athens, LLCCCN 112017 · All quality measures
Ownership
For profit
Certified
Feb 1, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Beds
42

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
11D1092043Landmark Hospital of Athens775 Sunset Drive, Athens, GA 30606AccreditationFeb 1, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Tracy Larose Individual Corporate Director Mar 10, 2020
Landmark Holdings of Florida, LLC Organization, Cape Girardeau, MO LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Sep 29, 2006 71.5%
Operational/Managerial Control Sep 29, 2006
KRB Investments, LLC Organization, Cape Girardeau, MO LLC 5% Or Greater Direct Ownership Interest May 7, 2008 23.75%
William K Kapp Individual 5% Or Greater Direct Ownership Interest Sep 29, 2006
Corporate Director Sep 29, 2006
Rebekah Palmatier Individual Operational/Managerial Control May 9, 2017

Owners & managing parties with NPI records 1

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 8

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

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1206662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773014400000",
    "number": "1740452820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 267",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637550267",
            "telephone_number": "573-331-8412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 SUNSET DRIVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "30606",
            "telephone_number": "573-335-1091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANDMARK HOSPITAL OF ATHENS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-28",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A",
        "authorized_official_last_name": "BOLLINGER",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "573-450-2530",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": null,
            "license": "APPLIED FOR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.