NPIMap

Organization Active NPI

Caldwell County Hospital, Inc

Doing business as Caldwell Medical Associates

  • Physician Assistant
  • Princeton, KY
National Provider Identifier
1891207460
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
CALDWELL COUNTY HOSPITAL, INC
Doing business as
Caldwell Medical Associates
Practice address
100 Medical Center Dr
Princeton, KY 42445-2430
Phone
(270) 365-0308
Fax
(270) 365-4152
NPI assigned
Nov 3, 2017
Last updated
Sep 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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 15

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary
Family Nurse Practitioner 363LF0000X NU
Certified Registered Nurse Anesthetist 367500000X NU
Mental Health Counselor 101YM0800X NU
Family Medicine Physician 207Q00000X NU
Cardiovascular Disease Physician 207RC0000X NU
Interventional Cardiology Physician 207RI0011X NU
Orthopaedic Surgery Physician 207X00000X NU
Otolaryngology Physician 207Y00000X NU
Occupational Medicine Physician 2083X0100X NU
Surgery Physician 208600000X KY
Urology Physician 208800000X NU
Foot & Ankle Surgery Podiatrist 213ES0103X NU
Physical Therapist 225100000X NU
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

100 Medical Center Dr
Princeton, KY 42445-2430

Mailing address

PO Box 410
Princeton, KY 42445-0410
Phone (270) 365-0320

Other practice location 1

320 Micbeth Dr
Princeton, KY 42445-6332
Phone (270) 365-0320

Other practice location 2

302 Micbeth Dr
Princeton, KY 42445-6332
Phone (270) 365-1225

Other names 1

  • Caldwell Medical Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20171211001612 KY Part B Supplier - Clinic/Group Practice 0749275014 Receives reassigned benefits from 39 practitioners
1 other NPI on this enrollment
Practice locations: Eddyville, KY; Fredonia, KY; Kuttawa, KY; Princeton, KY
O20181003003526 KY Part A Provider - Rural Health Clinic 0749275014 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Princeton, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891207460. Details of each certification follow.

Rural health clinic certification: CCN 188521

Legal name
CALDWELL COUNTY HOSPITAL, INC
Doing business as
CALDWELL MEDICAL ASSOCIATES
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 16, 2018
Last certification
Nov 16, 2018
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jun 2, 1947 in KY
Enrollment address
302 Micbeth Dr
Princeton, KY 42445-6332
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).

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

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 Sep 1, 2018
Nacy Elizabeth Butts Individual Corporate OfficerCfo Sep 1, 2018
Corporate DirectorCfo Sep 1, 2018
W-2 Managing EmployeeCfo Sep 1, 2018
Charles Littlejohn Individual Corporate DirectorBoard Member Sep 1, 2018
Joseph Falder Individual Corporate DirectorBoard Member Sep 1, 2018
Harold D Odegaard Individual Corporate OfficerCeo Sep 1, 2018
Corporate DirectorCeo Sep 1, 2018
W-2 Managing EmployeeCeo Sep 1, 2018
Monte Nesmith Individual Corporate DirectorBoard Member Sep 1, 2018
Martiza C Stallins Individual Corporate DirectorBoard Member Sep 1, 2018
Ellen Dunning Individual Corporate DirectorBoard Member Sep 1, 2018
Patricia Lander Individual Corporate DirectorBoard Member Sep 1, 2018
Michael Edmond Howard Individual Corporate DirectorBoard Member Sep 1, 2018
Jesse Rea Individual Corporate DirectorBoard Member Sep 1, 2018
John Bugg Individual Corporate DirectorBoard Member Sep 1, 2018
Joseph Gray Individual Corporate DirectorBoard Member Sep 1, 2018
Steve Woodward Individual Corporate OfficerBoard Member Sep 1, 2018

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 44

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 44

NPI Registry JSON

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

{
    "created_epoch": "1509667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788393600000",
    "number": "1891207460",
    "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": "270-365-0320",
            "fax_number": "270-365-4152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER DR",
            "city": "PRINCETON",
            "state": "KY",
            "postal_code": "424452430",
            "telephone_number": "270-365-0308",
            "fax_number": "270-365-4152"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 Micbeth Dr",
            "address_purpose": "LOCATION",
            "city": "Princeton",
            "state": "KY",
            "postal_code": "424456332",
            "country_code": "US",
            "telephone_number": "270-365-0320",
            "fax_number": "270-365-4152",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "302 Micbeth Dr",
            "address_purpose": "LOCATION",
            "city": "Princeton",
            "state": "KY",
            "postal_code": "424456332",
            "country_code": "US",
            "telephone_number": "270-365-1225",
            "fax_number": "270-365-4152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CALDWELL COUNTY HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-03",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "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": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Caldwell Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Princeton, KY

Sources for this page

Verify at the official NPI Registry.