NPIMap

Organization Active NPI

The Hospital Authority of Monroe County, Georgia

Doing business as Monroe County Hospital

  • Critical Access Hospital
  • Forsyth, GA
National Provider Identifier
1770684284
Registry record updated Jul 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
102121 Issued in GA
Legal business name
THE HOSPITAL AUTHORITY OF MONROE COUNTY, GEORGIA
Doing business as
Monroe County Hospital
Practice address
88 Martin Luther King Jr Dr
Forsyth, GA 31029-1682
Phone
(478) 994-2521
Fax
(478) 994-8798
NPI assigned
Sep 26, 2006
Last updated
Jul 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2010

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

Authorized official

Name
Mrs. Kay A Floyd
Title
Ceo
Phone
(478) 994-2521

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 102121 GA Primary

Addresses

Primary practice location

88 Martin Luther King Jr Dr
Forsyth, GA 31029-1682

Mailing address

PO Box 1068
Forsyth, GA 31029-1068
Phone (478) 994-2521

Other identifiers 2

IdentifierTypeStateIssuer
203585MedicaidGA
00001361AMedicaidGA

Other names 1

  • Monroe County Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040602000815 GA Part B Supplier - Clinic/Group Practice 6507848702 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Forsyth, GA
O20080325000248 GA Part A Provider - Critical Access Hospital 6507848702 Practice locations: Forsyth, GA
O20080325000348 GA Part A Provider - Critical Access Hospital 6507848702 Practice locations: Forsyth, GA

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1770684284. Details of each certification follow.

Hospital certification: CCN 111318

Legal name
THE HOSPITAL AUTHORITY OF MONROE COUNTY, GEORGIA
Doing business as
MONROE COUNTY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Sep 12, 2001
Last certification
May 15, 2024
Beds
25
Ownership / control type
Hospital district or authority
Organization structure
OtherNon-profit
Incorporated
Oct 13, 1954 in GA
Enrollment address
88 Martin Luther King Jr Dr
Forsyth, GA 31029-1682
Other Hospital Practice Location

Hospital certification: CCN 11Z318

Legal name
THE HOSPITAL AUTHORITY OF MONROE COUNTY, GEORGIA
Doing business as
MONROE COUNTY HOSPITAL
Organization structure
OtherNon-profit
Incorporated
Oct 13, 1954 in GA
Enrollment address
88 Martin Luther King Jr Dr
Forsyth, GA 31029-1682
Hospital Swing-Bed Unit

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Monroe County HospitalCCN 111318 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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
11D0263549Monroe County Hospital88 Martin Luther King Jr Drive, Forsyth, GA 31029AccreditationAug 21, 2027

National Provider Directory

National Provider Directory

Member organizations 2

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

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Megan Randall Individual Operational/Managerial ControlChief Operating Officer Nov 1, 2023
Chemelle Ralls Individual Operational/Managerial ControlController Nov 1, 2023
Kerry Trapnell Individual Corporate OfficerChief Executive Officer Nov 1, 2023
Corporate DirectorChief Executive Officer Nov 1, 2023
The Hospital Authority of Monroe County, Georgia Organization, Forsyth, GA Non-profit 5% Or Greater Direct Ownership Interest Mar 31, 2014 100%

Practitioners & affiliated clinicians

Practitioners 25

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 25

Affiliated clinicians 30

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

View all 30

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": "1278547200000",
    "number": "1770684284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1068",
            "city": "FORSYTH",
            "state": "GA",
            "postal_code": "310291068",
            "telephone_number": "478-994-2521",
            "fax_number": "478-994-8798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 MARTIN LUTHER KING JR DR",
            "city": "FORSYTH",
            "state": "GA",
            "postal_code": "310291682",
            "telephone_number": "478-994-2521",
            "fax_number": "478-994-8798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HOSPITAL AUTHORITY OF MONROE COUNTY, GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2010-07-08",
        "status": "A",
        "authorized_official_last_name": "FLOYD",
        "authorized_official_first_name": "KAY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "478-994-2521",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "GA",
            "license": "102121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203585",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00001361A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monroe County Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Forsyth, GA

Sources for this page

Verify at the official NPI Registry.