NPIMap

Organization Active NPI

Cartersville Medical Center LLC

Doing business as Cartersville Medical Center

  • General Acute Care Hospital
  • Cartersville, GA
National Provider Identifier
1780638833
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
CARTERSVILLE MEDICAL CENTER LLC
Doing business as
Cartersville Medical Center
Piedmont Cartersville Medical Center
Practice address
960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120-2129
Phone
(770) 382-1530
Fax
(770) 606-2127
NPI assigned
May 22, 2006
Last updated
Feb 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Authorized official

Name
Robert C Cross
Title
VP Government Reimbursement
Phone
(470) 271-3401

Specialties & licenses 1

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

Addresses

Primary practice location

960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120-2129

Mailing address

960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120-2129
Phone (770) 382-1530

Other identifiers 23

IdentifierTypeStateIssuer
000001625AMedicaidGA
04935056MedicaidMS
1012487MedicaidMI
11066AMedicaidSC
2339222MedicaidOH
0018091580003MedicaidPA
0110030MedicaidTN
269740MedicaidOR
EMO0030NMedicaidAL
100504458MedicaidNV
60022246MedicaidNJ
158337300OtherDEPT OF LABOR
3075476OtherTNBLUECARE
01698MedicaidND
146981901MedicaidTX
82554300MedicaidWI
911642700MedicaidFL
01300318MedicaidKY
089328MedicaidAZ
1131399MedicaidKY
1704857MedicaidLA
29686521MedicaidCO
3570OtherGABLUE CROSS

Other names 2

  • Cartersville Medical Center Doing business as
  • Piedmont Cartersville Medical Center Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address CARTERSVILLE.COCCA.GAA@CCDA.HCADIRECT.NET
CONNECT URL https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service Other Ciox Health

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040304000831 GA Part B Supplier - Clinic/Group Practice 9335037134 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Atlanta, GA; Cartersville, GA; Marietta, GA
O20070626000364 GA Part A Provider - Hospital 1052410420 Practice locations: Cartersville, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780638833. Details of each certification follow.

Hospital certification: CCN 110030

Legal name
CARTERSVILLE MEDICAL CENTER LLC
Doing business as
PIEDMONT CARTERSVILLE MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Apr 2, 2026
Beds
139
Ownership / control type
Private (not for profit)
Most recent change of ownership
Feb 1, 1999 (2 total)
Organization structure
LLCNon-profit
Enrollment address
960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120-2129
Main/Primary Hospital Location
Hospital subgroups
Acute care

Other NPIs on the same Medicare enrollment 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Piedmont Cartersville Medical CenterCCN 110030 · All quality measures
Overall star rating
3 of 5
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
Tax ID family
Cartersville Medical Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

100 Market Place Blvd
Ste 109
Cartersville, GA 30121
Phone (470) 490-2941

962 Joe Frank Harris Pkwy SE
Ste 101
Cartersville, GA 30120
Phone (470) 490-2860

962 Joe Frank Harris Pkwy SE
Ste 104
Cartersville, GA 30120
Phone (770) 386-0090

970 Joe Frank Harris Pkwy SE
Ste 160
Cartersville, GA 30120
Phone (470) 357-6226

970 Joe Frank Harris Pkwy SE
Ste 240
Cartersville, GA 30120
Phone (470) 490-1901

970 Joe Frank Harris Pkwy SE
Ste 280
Cartersville, GA 30120
Phone (770) 607-1089

Interoperability endpoints

  • Direct secure messaging: cartersville.cocca.gaa@ccda.hcadirect.net
  • Direct secure messaging: william.thomas@cmc.gadirect.net

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Thomas Arnold Individual Corporate Officer Aug 1, 2021
Michael J Mandl Individual Corporate Officer Aug 1, 2021
Lori E Rakes Individual W-2 Managing EmployeeCeo Mar 12, 2023
Piedmont Healthcare Inc Organization, Atlanta, GA Corporation, Non-profit, Chain home office Operational/Managerial Control Aug 1, 2021 100%
Lindsay B Gard Individual W-2 Managing EmployeeCfo Jan 1, 2024
Robert C Cross Individual Corporate Officer Aug 1, 2021
Elizabeth Leddy Individual Corporate Officer Aug 1, 2021
Piedmont Cartersville Hospital, Inc. Organization, Atlanta, GA Created for acquisition, Corporation, Holding company, Non-profit 5% Or Greater Direct Ownership Interest Aug 1, 2021 100%

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 29

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

View all 29

Practitioners & affiliated clinicians

Practitioners 41

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 41

Affiliated clinicians 337

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

View all 337

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708905600000",
    "number": "1780638833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 JOE FRANK HARRIS PKWY SE",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202129",
            "telephone_number": "770-382-1530",
            "fax_number": "770-606-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 JOE FRANK HARRIS PKWY SE",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202129",
            "telephone_number": "770-382-1530",
            "fax_number": "770-606-2127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARTERSVILLE MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VP GOVERNMENT REIMBURSEMENT",
        "authorized_official_telephone_number": "470-271-3401"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000001625A",
            "state": "GA"
        },
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            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04935056",
            "state": "MS"
        },
        {
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            "desc": "MEDICAID",
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            "identifier": "1012487",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11066A",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2339222",
            "state": "OH"
        },
        {
            "code": "05",
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            "issuer": null,
            "identifier": "0018091580003",
            "state": "PA"
        },
        {
            "code": "05",
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            "issuer": null,
            "identifier": "0110030",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269740",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EMO0030N",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100504458",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60022246",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "158337300",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECARE",
            "identifier": "3075476",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01698",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146981901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82554300",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "911642700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01300318",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "089328",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1131399",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1704857",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "29686521",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3570",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CARTERSVILLE.COCCA.GAA@CCDA.HCADIRECT.NET",
            "affiliation": "N",
            "endpointDescription": "Please contact CORP.HCACEP@HCAHealthcare.com for information regarding validation steps that may be required to ensure CCDs sent to the listed direct address are successfully received.",
            "address_1": "960 Joe Frank Harris Pkwy SE",
            "city": "Cartersville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301202129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "esmd.cioxhealth.com and OID is '2.16.840.1.113883.3.6635.1.1'",
            "affiliationName": "Ciox Health",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "925 N Point Pkwy",
            "city": "Alpharetta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300055210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Cartersville Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cartersville Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Piedmont Cartersville Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cartersville, GA

Sources for this page

Verify at the official NPI Registry.