NPIMap

Organization Active NPI

Sylacauga Health Care Authority Inc

Doing business as Coosa Valley Medical Center

  • Rural Acute Care Hospital
  • Sylacauga, AL
National Provider Identifier
1972527265
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
License
11871 Issued in AL
Legal business name
SYLACAUGA HEALTH CARE AUTHORITY INC
Doing business as
Coosa Valley Medical Center
Practice address
315 W Hickory St
Sylacauga, AL 35150-2913
Phone
(256) 401-4000
NPI assigned
Jul 27, 2006
Last updated
Apr 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Authorized official

Name
Glenn Sisk
Title
Ceo
Phone
(256) 401-4604

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X 11871 AL Primary

Addresses

Primary practice location

315 W Hickory St
Sylacauga, AL 35150-2913

Mailing address

315 W Hickory St
Sylacauga, AL 35150-2913
Phone (256) 401-4000

Other identifiers 1

IdentifierTypeStateIssuer
HOS0164HMedicaidAL

Other names 1

  • Coosa Valley Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040622001591 AL Part A Provider - Hospital 5294710398 Practice locations: Sylacauga, AL
O20080929000649 AL Part A Provider - Hospital 5294710398 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sylacauga, AL

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1972527265. Details of each certification follow.

Hospital certification: CCN 010164

Legal name
THE SYLACAUGA HEALTH CARE AUTHORITY
Doing business as
COOSA VALLEY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Aug 2, 2004
Last certification
Nov 15, 2018
Beds
168
Ownership / control type
Hospital district or authority
Organization structure
CorporationNon-profit
Incorporated
Jan 20, 1988 in AL
Enrollment address
315 W Hickory St
Sylacauga, AL 35150-2913
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Hospital certification: CCN 01S164

Legal name
THE SYLACAUGA HEALTH CARE AUTHORITY
Doing business as
COOSA VALLEY MEDICAL CENTER
Organization structure
CorporationNon-profit
Incorporated
Jan 20, 1988 in AL
Enrollment address
315W Hickory St
Sylacauga, AL 35150-2913
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

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 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Coosa Valley Medical CenterCCN 010164 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Jesse L. Cleveland Individual Corporate DirectorBoard Member Jun 22, 2004
Mamoun R Pacha Individual Corporate DirectorBoard Member Aug 1, 2006
Corporate Director Aug 1, 2006
Jerry Leonard Fielding Individual Corporate DirectorBoard Member Jun 22, 2004
Stephen R Bowen Individual Corporate DirectorBoard Member Aug 1, 2007
Corporate Director Aug 1, 2007
Glenn Chamblee Sisk Individual Operational/Managerial ControlChief Executive Officer May 8, 1980
John Floyd Individual Corporate DirectorBoard Member Jun 22, 2004
Shirley Spears Individual Corporate DirectorBoard Member Aug 1, 2017
Wayne Hall Individual Corporate DirectorBoard Member Aug 1, 2021
William McCormick Individual W-2 Managing EmployeeCfo Jan 17, 2023
Roland Thacker Individual W-2 Managing Employee Mar 25, 2015

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Coosa Valley HospiceSylacauga, AL, CCN 011661 Hospice 5% Or Greater Direct Ownership Interest Mar 8, 2007
Nix Family MedicineChildersburg, AL, CCN 018503 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 1, 2023
Jul 1, 2023

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 17

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 17

Affiliated clinicians 143

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

View all 143

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682553600000",
    "number": "1972527265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W HICKORY ST",
            "city": "SYLACAUGA",
            "state": "AL",
            "postal_code": "351502913",
            "telephone_number": "256-401-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W HICKORY ST",
            "city": "SYLACAUGA",
            "state": "AL",
            "postal_code": "351502913",
            "telephone_number": "256-401-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYLACAUGA HEALTH CARE AUTHORITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-26",
        "status": "A",
        "authorized_official_last_name": "SISK",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "256-401-4604"
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "AL",
            "license": "11871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HOS0164H",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coosa Valley Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coosa Valley Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sylacauga, AL

Sources for this page

Verify at the official NPI Registry.