Active NPI
Johnson Memorial Hospital, Inc.
- General Acute Care Hospital
- Stafford Springs, CT
National Provider Identifier
1972728442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Acute Care Hospital
- License
- 0072
- Legal business name
- JOHNSON MEMORIAL HOSPITAL, INC.
- Practice address
- 201 Chestnut Hill Rd
Stafford Springs, CT 06076-4005 - Phone
- (860) 684-4251
- NPI assigned
- Apr 17, 2007
- Last updated
- Mar 3, 2026
- Organization subpart
- Yes
- Parent organization
- TRINITY HEALTH - NEW ENGLAND, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Antonio Perugino
- Title
- VP and Regional Cfo
- Phone
- (860) 714-4714
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 0072 | CT | Primary |
| Cardiovascular Disease Physician | 207RC0000X | 0072 | CT |
Addresses
Primary practice location
201 Chestnut Hill Rd
Stafford Springs, CT 06076-4005
Mailing address
201 Chestnut Hill Rd
Stafford Springs, CT 06076-4005
Phone (860) 684-4251
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4041687 | Medicaid | CT | |
| 4024980 | Medicaid | CT |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Cobius Healthcare Solutions |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 2
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1972728442. Details of each certification follow.
Hospital certification: CCN 070008
- Legal name
- JOHNSON MEMORIAL HOSPITAL INC
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Oct 21, 2014
- Beds
- 92
- Ownership / control type
- Private (not for profit)
- Most recent change of ownership
- Dec 31, 2015 (5 total)
- Organization structure
- Corporation
- Incorporated
- Jan 1, 2016 in CT
- Enrollment address
- 201 Chestnut Hill Rd
Stafford Springs, CT 60764005 - Hospital subgroups
- Acute care, Psychiatric unit
Related certifications (CCN) 1
Facilities connected through Provider of Services related, parent or unit certification numbers.
-
- Psychiatric Hospital Unit
- Stafford Springs, CT
- NPI 1053480293
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Psychiatric Hospital Unit
- Stafford Springs, CT
- NPI 1053480293
4486959137
-
- General Acute Care Hospital
- Stafford Springs, CT
- NPI 1932123569
4486959137
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Psychiatric Hospital Unit
- Stafford Springs, CT
- NPI 1053480293
O20160218000626
-
- General Acute Care Hospital
- Stafford Springs, CT
- NPI 1932123569
O20160218000626
Care Compare: Hospital
Medicare Care Compare- Listed as
- Johnson Memorial Hospital
- Overall star rating
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
National Provider Directory
National Provider Directory- Tax ID family
- Johnson Memorial Hospital Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Nursing Facility/Intermediate Care Facility
- Storrs, CT
- NPI 1265826796
-
- General Acute Care Hospital
- Saint Paul, IN
- NPI 1487016549
Ownership & related parties
All disclosed owners & managing parties 21
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Wesley Knauft | Corporate Director | Jan 1, 2025 | |
| Garrett Casey | Corporate Director | Jan 1, 2025 | |
| Juan Miguel Betancourt | Corporate Director | Jan 1, 2020 | |
| James M Harris | Corporate Officer | Feb 7, 2017 | |
| Operational/Managerial Control | Feb 21, 2019 | ||
| Barbara Mullen | Corporate Director | Jan 1, 2019 | |
| Walter Harrison | Corporate Officer | Jan 1, 2024 | |
| Corporate Director | Jan 1, 2019 | ||
| John Kinney | Corporate Director | Jan 1, 2024 | |
| Robert Anthony | Contracted Managing Employee | Sep 1, 2017 | |
| Corporate Officer | Jan 1, 2019 | ||
| Michelle Theroux | Corporate Director | Jan 1, 2022 | |
| Joann Price | Corporate Officer | Jan 1, 2024 | |
| Corporate Director | Jan 1, 2019 | ||
| Arosha Jayawickrema | Corporate Director | Jan 1, 2024 | |
| Nancy Kroeber | Corporate Director | Jan 1, 2022 | |
| David Carter | Corporate Officer | Oct 3, 2022 | |
| Corporate Director | Oct 3, 2022 | ||
| Antonio S Perugino | Corporate Officer | Nov 4, 2024 | |
| Operational/Managerial Control | Nov 4, 2024 | ||
| Trinity Health of New England Corporation Inc | 5% Or Greater Indirect Ownership Interest | Jan 1, 2016 | 100% |
| Trinity Health Corporation | 5% Or Greater Indirect Ownership Interest | Jan 1, 2016 | 100% |
| Robert J Roose | Corporate Officer | Apr 20, 2022 | |
| Operational/Managerial Control | Apr 20, 2022 | ||
| Tina Weatherwax Grant | Corporate Director | Jan 1, 2025 | |
| Stuart Kilpinen | Operational/Managerial Control | Jun 10, 2023 | |
| Karl J Krapek | Corporate Director | Jan 1, 2021 | |
| Sheri Lemieux | Corporate Officer | Jan 1, 2019 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
Practitioners & affiliated clinicians
Practitioners 6
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.
-
- Clinical Social Worker
- Hartford, CT
- NPI 1023316692
-
- Clinical Social Worker
- Plainville, CT
- NPI 1255577672
-
- Clinical Social Worker
- Manchester, CT
- NPI 1467762781
-
- Cardiovascular Disease Physician
- Hartford, CT
- NPI 1609874627
-
- Cardiovascular Disease Physician
- Enfield, CT
- NPI 1598705832
-
- Physician Assistant
- Coventry, RI
- NPI 1306879242
Affiliated clinicians 242
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Hospitalist Physician
- Hartford, CT
- NPI 1194923128
-
- Hospitalist Physician
- Waterbury, CT
- NPI 1558989681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1772496000000",
"number": "1972728442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 CHESTNUT HILL RD",
"city": "STAFFORD SPRINGS",
"state": "CT",
"postal_code": "060764005",
"telephone_number": "860-684-4251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 CHESTNUT HILL RD",
"city": "STAFFORD SPRINGS",
"state": "CT",
"postal_code": "060764005",
"telephone_number": "860-684-4251"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JOHNSON MEMORIAL HOSPITAL, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "TRINITY HEALTH - NEW ENGLAND, INC.",
"enumeration_date": "2007-04-17",
"last_updated": "2026-03-03",
"certification_date": "2026-03-03",
"status": "A",
"authorized_official_last_name": "PERUGINO",
"authorized_official_first_name": "ANTONIO",
"authorized_official_title_or_position": "VP AND REGIONAL CFO",
"authorized_official_telephone_number": "860-714-4714"
},
"taxonomies": [
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "CT",
"license": "0072",
"primary": true
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "CT",
"license": "0072",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4041687",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4024980",
"state": "CT"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.1068.1",
"affiliationName": "Cobius Healthcare Solutions",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "2720 Dundee Rd # 302",
"city": "Northbrook",
"state": "IL",
"country_code": "US",
"postal_code": "600622609",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Stafford Springs, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.