Russell County Hospital
Organization Active NPI Critical Access Hospital · Russell Springs, KY
NPI 1902963473 · NPPES record last updated Jun 10, 2024
Key facts
- NPI
- 1902963473
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- License
- 100529 (KY)
- Legal business name
- RUSSELL COUNTY HOSPITAL
- Practice address
- 153 Dowell Rd
Russell Springs, KY 42642-4579 - Phone
- (270) 866-4753
- Fax
- (270) 866-7148
- NPI assigned
- Jan 3, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Nequila Norris
- Title
- Dir of Finance
- Phone
- (270) 858-6936
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 7
Related certifications (CCN) 1
Practitioners 22
-
Stephen Aitken, CRNA
-
Susan Bradshaw, APRN FNP
-
James Michael Brown, D.O.
-
Ashley L Collins, APRN
-
Cassidy Emerson, MSN, APRN, FNP-C
-
Lovegildo S Garcia Jr., M.D.
-
Liesel C Grentz, D.O.
-
Tammy Jo Hill, APRN
-
Taylor Jones, APRN
-
Kimberly Meyer, MSNARNP
-
Frank Denton Miller, M.D.
-
Richard B Perkins, M.D.
-
Latisha Ann Popplewell, NP-C
-
Terani Robertson, ARNP
-
Siby Sebastian, MD
-
Tonya E Shea, DO
-
Tommy Warren Shelton, M.D.
-
April Nicole Turner, APRN
Affiliated clinicians 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Hospital certification: CCN 18Z330
- Legal name
- RUSSELL COUNTY HOSPITAL
- Doing business as
- RUSSELL COUNTY HOSPITAL SWING
- Organization structure
- Corporation · Non-profit
- Incorporated
- May 31, 1979 in KY
- Enrollment address
- 153 Dowell Rd
Russell Springs, KY 42642-4579
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Neal Dalton |
Operational/Managerial Control | Jan 1, 2015 | |
| Winfrey Bates |
Corporate Director | Jan 1, 2019 | |
| Nequila Norris |
Corporate Director |
Oct 25, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071213000183 | KY | Part a Provider - Critical Access Hospital | 6204887243 |
1 other NPI on this enrollment Practice locations: Russell Springs, KY |
National Provider Directory
- Tax ID family
- Russell Co Hospital
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | 100529 | KY | Yes |
Addresses
Primary practice location
153 Dowell Rd
Russell Springs, KY 42642-4579
Mailing address
PO Box 1610
Russell Springs, KY 42642-1610
Phone (270) 866-4753
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12700621 | Medicaid | KY |
Other names
- RUSSELL COUNTY HOSPITAL SWING
Other providers in Russell Springs, KY
- Russell County Hospital
- Russell County Hospital
- Russell County Hospital
- Russell County Hospital
- Russell County Hospital
- Russell County Radiology, PSC
- Russell Springs Pharmacy
- RX Drug Monitoring Laboratory, LLC
- Mercy Grace Shirk
- Joseph Chase Skaggs I
All providers in Russell Springs, KY · Critical Access Hospital in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2024. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.