Jennie Stuart Medical Center Inc
Organization Active NPI Rural Health Clinic/Center · Hopkinsville, KY
NPI 1891415972 · NPPES record last updated Nov 13, 2025
Key facts
- NPI
- 1891415972
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- JENNIE STUART MEDICAL CENTER INC
- Practice address
- 222 W 18TH St
Hopkinsville, KY 42240-1963 - Phone
- (270) 886-4625
- NPI assigned
- Aug 30, 2022
- Organization subpart
- No
Authorized official
- Name
- Autumn Bailey
- Title
- Director of PFS and Managed Care
- Phone
- (270) 887-0100
Owners & managing parties with NPI records 4
-
Tanner Jackson Parrent, M.D.
-
Tarek Toubia, M.D.
Other NPIs on the same Medicare enrollment 7
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 16
Member of 1
Related certifications (CCN) 1
Change of ownership 1
Facilities with the same owner 10
Practitioners 113
-
Jonathan L Abbott, M.D.
-
Dennis Dale Barnes Jr., APRN
-
Nicholas Basham, PA
-
David P Bealle, MD
-
Kara Bean, AU.D.
-
Natalie Pace Billingham, MD, MSCI
-
Patricia Ann Blewett, M.D.
-
Jessica Bridgforth, APRN
-
Tracey Bullard, FNP
-
Derek Evan Burkhart, APRN-FNP
-
Timothy Tinyau Chang, MD PHD
-
Shannon Elizabeth Cole, DNP,APRN,BC
-
Misty G Cook, ACNP
-
Dixon Lynn Craft, PA-C
-
Linda M Crump, ARNP
-
Mackenzie Denton, DO
-
Yve Nichole Dollison, APRN
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 18D1058268 | Jennie Stuart Family Health , Main a Department | Certificate of waiver | Sep 4, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KY
Rural health clinic certification: CCN 188558
- Legal name
- JENNIE STUART MEDICAL CENTER INC
- Doing business as
- JENNIE STUART FAMILY HEALTH
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Dec 5, 2022
- Last certification
- Sep 28, 2017
- Ownership / control type
- 1B
- Organization structure
- Corporation · Non-profit
- Incorporated
- Feb 19, 1913 in KY
- Enrollment address
- 222 W 18TH St
Hopkinsville, KY 42240-1963 - Related CCNs
- 180051
All disclosed owners & managing parties 21
| Name | Role | Since | Share |
|---|---|---|---|
| Beth a McCraw |
Corporate Officer |
Jul 27, 2018 | |
| W-2 Managing Employee |
Jul 27, 2018 | ||
| Elizabeth Shelton |
Corporate Director |
Jan 1, 2021 | |
| Eric Lee |
Contracted Managing Employee |
Dec 1, 2007 | |
| Corporate Officer |
Dec 1, 2007 | ||
| Jared Larry Antczak |
Corporate Director |
Oct 1, 2025 | |
| Deeann W Sova |
Corporate Director |
Jan 1, 2024 | |
| Mark Laramee |
Contracted Managing Employee |
Jul 1, 2022 | |
| Corporate Officer |
Jul 1, 2022 | ||
| Hollis White |
Corporate Director |
Jan 1, 2021 | |
| Craig Self |
Corporate Director |
Oct 1, 2025 | |
| Leslie H Carroll |
Corporate Director |
Apr 22, 2019 | |
| Tarek Toubia |
Corporate Director |
Jan 1, 2025 | |
| Alissa L Young |
Corporate Director |
Jan 1, 2018 | |
| Lynn C Lingafelter |
Corporate Director |
Oct 1, 2025 | |
| Tanner Jackson Parrent |
Corporate Director |
Jan 1, 2025 | |
| Lydia Francene Gilmer |
Corporate Director |
Apr 24, 2025 | |
| QHR Health LLC |
Operational/Managerial Control | Dec 5, 2022 | |
| Autumn S Bailey |
W-2 Managing Employee |
Aug 1, 2017 | |
| Phillip Tribble |
Corporate Director |
Nov 1, 2010 | |
| Charles Turner |
Corporate Director |
Jan 1, 2018 | |
| Deaconess Health Kentucky Inc |
5% Or Greater Indirect Ownership Interest | Oct 1, 2025 | 100% |
| Marty Bozarth |
Corporate Director |
Jan 1, 2021 | |
| Carter Hendricks |
Corporate Director |
Jan 1, 2015 |
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Dec 5, 2022 | Change of Ownership |
Jennie Stuart Medical Group |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040609001506 | KY | Part B Supplier - Clinic/Group Practice | 4183607252 |
Receives reassigned benefits from 155 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Hopkinsville, KY; Trenton, KY; Russellville, KY |
| O20221230002510 | KY | Part a Provider - Rural Health Clinic | 4183607252 | Practice locations: Hopkinsville, KY |
National Provider Directory
- Tax ID family
- Jennie Stuart Medical C
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
222 W 18TH St
Hopkinsville, KY 42240-1963
Mailing address
PO Box 2400
Hopkinsville, KY 42241-2400
Other names
- JENNIE STUART FAMILY HEALTH
Other providers in Hopkinsville, KY
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- Jennie Stuart Medical Center Inc
- Jennie Stuart Medical Center Inc
- Jennie Stuart Medical Center Inc
- Jillians LLC
- John E. Cotthoff, M.D., PSC
- John M Colby MD
- Johnson Family Chiropractic Inc
All providers in Hopkinsville, KY · Rural Health Clinic/Center in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.