NPIMap

Organization Active NPI

Adventist Health System Georgia, Inc.

Doing business as AdventHealth Murray

  • General Acute Care Hospital
  • Chatsworth, GA
National Provider Identifier
1750776571
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
105575 Issued in GA
Legal business name
ADVENTIST HEALTH SYSTEM GEORGIA, INC.
Doing business as
AdventHealth Murray
Practice address
707 Old Dalton Ellijay Rd
Chatsworth, GA 30705-2029
Phone
(706) 695-4564
Fax
(706) 517-2076
NPI assigned
Mar 30, 2015
Last updated
Jan 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Authorized official

Name
Christopher Self
Title
President/Ceo
Phone
(706) 879-4710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 105575 GA Primary

Addresses

Primary practice location

707 Old Dalton Ellijay Rd
Chatsworth, GA 30705-2029

Mailing address

707 Old Dalton Ellijay Rd
Chatsworth, GA 30705-2029
Phone (706) 695-4564

Other identifiers 1

IdentifierTypeStateIssuer
00001383AMedicaidGA

Other names 2

  • AdventHealth Murray Doing business as
  • Murray Medical Center Former legal business name

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://www.mettles.com/ Other
CONNECT URL https://cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other CMS HIH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150729010177 GA Part A Provider - Hospital 0840251336 Practice locations: Chatsworth, GA; East Ellijay, GA; Blue Ridge, GA; Fort Oglethorpe, GA; Dalton, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750776571. Details of each certification follow.

Hospital certification: CCN 110050

Legal name
ADVENTIST HEALTH SYSTEM GEORGIA INC
Doing business as
ADVENTHEALTH MURRAY
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Apr 21, 2024
Beds
42
Ownership / control type
Private (not for profit)
Most recent change of ownership
May 1, 2015 (4 total)
Organization structure
CorporationNon-profit
Incorporated
Jan 15, 1981 in GA
Enrollment address
707 Old Dalton Ellijay Rd
Chatsworth, GA 30705-2029
Main/Primary Hospital Location
Hospital subgroups
General

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Adventhealth MurrayCCN 110050 · All quality measures
Overall star rating
5 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Gordon Hospital7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Member organizations 4

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 31

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

NameRoleSinceShare
David Lance Individual Corporate DirectorDirector Aug 18, 2005
Karen Jean Bell Individual Corporate OfficerVice President Dec 1, 2021
Alan Guyton, Jr Individual Corporate OfficerVice President/Director Apr 20, 2020
Corporate DirectorVice President/Director Apr 20, 2020
Brittany Pittman Individual Corporate DirectorDirector Jun 4, 2015
Jeffrey Graff Individual Corporate OfficerAssistant Secretary Sep 11, 2014
Daniel S Ahn Individual Corporate DirectorDirector Jan 1, 2023
Joseph Hill Individual Corporate OfficerVice President Oct 1, 2021
Gary Rustad Individual Corporate DirectorAssistant Secretary Nov 11, 2019
Madison Barton Individual Corporate DirectorDirector Aug 22, 2024
Karsten Randolph Individual Corporate OfficerAssistant Secretary Aug 2, 2021
Mitchell Leonard Individual Corporate DirectorDirector Mar 1, 2016
Donald Livesay Individual Corporate DirectorDirector Feb 22, 2018
Edward Pelote Individual Corporate OfficerVice President Dec 12, 2024
James M Brown Individual Corporate DirectorDirector Jan 1, 2017
Michael Saunders Individual Corporate OfficerDirector/President Feb 22, 2007
Michael Ciurea Individual Contracted Managing EmployeeVP/Administrator Dec 15, 2024
Operational/Managerial ControlVP/Administrator Dec 15, 2024
Michael J Thompson Individual Corporate OfficerDirector/Chair Jan 29, 2023
Corporate DirectorDirector/Chair Jan 29, 2023
Paul C Rathbun Individual Corporate DirectorDirector Sep 11, 2014
Thomas Brown Individual Corporate DirectorDirector Jan 24, 2008
Adventist Health System Sunbelt Healthcare Corporation Organization, Altamonte Springs, FL Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest May 1, 2015 100%
Amanda Brady Individual Corporate OfficerAssistant Secretary Feb 27, 2020
Justin O Birmele Individual Contracted Managing EmployeeCeo Jun 15, 2025
Corporate OfficerCeo Jun 15, 2025
Operational/Managerial ControlCeo Jun 15, 2025
Stephen D Gotshall Individual Contracted Managing EmployeeVice President Apr 10, 2022
Corporate OfficerVice President Aug 25, 2022
Operational/Managerial ControlVice President Apr 10, 2022
Toni Berrios Individual Corporate OfficerAssistant Secretary Aug 25, 2022
David P Banks Individual Corporate OfficerAssistant Secretary Aug 25, 2022
Haney Vincent Individual Corporate OfficerAssistant Secretary Dec 9, 2021
Thomas L Garcia Individual Corporate DirectorDirector Mar 15, 2022
Hak J Lee Individual Corporate DirectorDirector Dec 12, 2024
David L Huffman Individual Corporate OfficerAssistant Secretary/ Officer Feb 27, 2020
Robert C Foltz Individual Corporate OfficerAssistant Secretary Sep 11, 2014
Lynn Addiscott Individual Corporate OfficerAssistant Secretary Aug 18, 2005

Owners & managing parties with NPI records 4

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

Facilities with the same owner 85

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

View all 85

Practitioners & affiliated clinicians

Practitioners 5

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.

Affiliated clinicians 206

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

View all 206

NPI Registry JSON

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1750776571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 OLD DALTON ELLIJAY RD",
            "city": "CHATSWORTH",
            "state": "GA",
            "postal_code": "307052029",
            "telephone_number": "706-695-4564",
            "fax_number": "706-517-2076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 OLD DALTON ELLIJAY RD",
            "city": "CHATSWORTH",
            "state": "GA",
            "postal_code": "307052029",
            "telephone_number": "706-695-4564",
            "fax_number": "706-517-2076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH SYSTEM GEORGIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-30",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "SELF",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "706-879-4710"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "GA",
            "license": "105575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00001383A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com/",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "CMS HIH",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "7500 Security Blvd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212441849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "AdventHealth Murray",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AdventHealth Murray",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Murray Medical Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Chatsworth, GA

Sources for this page

Verify at the official NPI Registry.