NPIMap

Organization Active NPI

Caldwell County Hospital, Inc.

Doing business as Caldwell Medical Associates

  • Rural Health Clinic/Center
  • Eddyville, KY
National Provider Identifier
1780464826
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CALDWELL COUNTY HOSPITAL, INC.
Doing business as
Caldwell Medical Associates
Practice address
403 W Fairview Ave
Eddyville, KY 42038-8259
Phone
(270) 388-6054
Fax
(270) 365-4152
NPI assigned
Oct 5, 2023
Last updated
Sep 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Authorized official

Name
Teresa L. Carpenter
Title
Director
Phone
(270) 365-0238

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

403 W Fairview Ave
Eddyville, KY 42038-8259

Mailing address

PO Box 410
Princeton, KY 42445-0410
Phone (270) 365-0300

Other names 1

  • Caldwell Medical Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240110004452 KY Part A Provider - Rural Health Clinic 0749275014 Practice locations: Eddyville, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780464826. Details of each certification follow.

Rural health clinic certification: CCN 188568

Legal name
CALDWELL COUNTY HOSPITAL, INC
Doing business as
CALDWELL MEDICAL ASSOCIATES
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 7, 2024
Last certification
Jun 7, 2024
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
403 W Fairview Ave
Eddyville, KY 42038-8259
Related CCNs
181322

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 6

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

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
18D2261378Caldwell Medical Associates Eddyville Clinic403 W Fairview Ave, Eddyville, KY 42038Certificate of waiverMay 30, 2028

National Provider Directory

National Provider Directory
Tax ID family
Mike Littlejohn7 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.

Locations

91 Cedar St
Kuttawa, KY 42055
Phone (270) 388-7380

550 US Highway 62 W
Ste 400
Princeton, KY 42445
Phone (270) 365-0300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GIDFCD

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
David Lee Oliver Individual Corporate DirectorBoard Member Jan 1, 2023
Nacy Elizabeth Butts Individual Corporate OfficerCeo Jan 1, 2023
Corporate DirectorCfo Jan 1, 2023
W-2 Managing EmployeeCfo Jan 1, 2023
Charles Littlejohn Individual Corporate DirectorBoard Member Jan 1, 2023
Joseph Falder Individual Corporate DirectorBoard Member Jan 1, 2023
Harold D Odegaard Individual Corporate OfficerCeo Jan 1, 2021
Corporate DirectorCeo Jan 1, 2021
W-2 Managing EmployeeCeo Jan 1, 2021
Monte Nesmith Individual Corporate DirectorBoard Member Jan 1, 2023
Martiza C Stallins Individual Corporate DirectorBoard Member Jan 1, 2023
Ellen Dunning Individual Corporate DirectorBoard Member Jan 1, 2023
Patricia Lander Individual Corporate DirectorBoard Member Jan 1, 2023
Michael Edmond Howard Individual Corporate DirectorBoard Member Jan 1, 2023
Jesse Rea Individual Corporate DirectorBoard Member Jan 1, 2023
John Bugg Individual Corporate DirectorBoard Member Jan 1, 2023
Joseph Gray Individual Corporate DirectorBoard Member Jan 1, 2023
Steve Woodward Individual Corporate DirectorBoard Member Jan 1, 2023

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 39

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 39

NPI Registry JSON

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

{
    "created_epoch": "1696464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756944000000",
    "number": "1780464826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 410",
            "city": "PRINCETON",
            "state": "KY",
            "postal_code": "424450410",
            "telephone_number": "270-365-0300",
            "fax_number": "270-365-4152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W FAIRVIEW AVE",
            "city": "EDDYVILLE",
            "state": "KY",
            "postal_code": "420388259",
            "telephone_number": "270-388-6054",
            "fax_number": "270-365-4152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALDWELL COUNTY HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-05",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "270-365-0238"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Caldwell Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eddyville, KY

Sources for this page

Verify at the official NPI Registry.