NPIMap

Organization Active NPI

Cumberland County Hospital System Inc

  • Special Hospital
  • Fayetteville, NC
National Provider Identifier
1982607115
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Special HospitalTaxonomy code 284300000X
Legal business name
CUMBERLAND COUNTY HOSPITAL SYSTEM INC
Practice address
150 Robeson St
Fayetteville, NC 28301-5570
Phone
(910) 615-1000
Fax
(910) 615-1046
NPI assigned
May 23, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

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

Authorized official

Name
Mr. Joseph Bart Fiser
Title
VP Managed Care and Revenue Cycle
Phone
(910) 615-5572

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X H0275 NC
Special Hospital 284300000X Primary

Addresses

Primary practice location

150 Robeson St
Fayetteville, NC 28301-5570

Mailing address

PO Box 788
Fayetteville, NC 28302-0788
Phone (910) 615-1000

Other identifiers 1

IdentifierTypeStateIssuer
3402014MedicaidNC

Other names 1

  • Highsmith-Rainey Speciality Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040412001006 NC Part A Provider - Hospital 1850204041 Practice locations: Fayetteville, NC

Hospital certification: CCN 342014

Legal name
CUMBERLAND COUNTY HOSPITAL SYSTEM INC
Doing business as
HIGHSMITH-RAINEY MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Long-term
Participating since
Feb 1, 2003
Last certification
Jun 27, 2018
Beds
112
Ownership / control type
Private (not for profit)
Most recent change of ownership
Jun 1, 2004 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Jul 7, 1964 in NC
Enrollment address
150 Robeson Street
Fayetteville, NC 28301-5570
Main/Primary Hospital Location
Hospital subgroups
Long-term

Hospital certification: CCN 340164

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
COLUMBIA HIGH SMITH RAINEY MEM HOSPITA
Certification status
Terminated Voluntary: merger or closure, May 1, 1999
Provider type (POS)
Hospital – Short-term
Participating since
May 14, 1983
Last certification
Mar 25, 1998
Beds
133
Ownership / control type
Private (for profit)
Facility address
150 Robeson Street
Fayetteville, NC 28301

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Long-term care hospital

Medicare Care Compare
Listed as
Highsmith Rainey Memorial HospitalCCN 342014
Ownership
Non-profit
Certified
Feb 1, 2003
Medicare certification status
ActiveFrom the Provider of Services file
Beds
112

National Provider Directory

National Provider Directory
Tax ID family
Cumberland County EMS50 organizations share this tax ID, including this one

Other organizations with this tax ID 49

Organizations that report the same tax identification number in the National Provider Directory.

View all 49

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Jeannette Council Individual Corporate DirectorBoard Member Aug 7, 2000
Billy King Individual Corporate Director Dec 3, 1990
Cumberland County Hospital System Inc Organization, Fayetteville, NC Non-profit 5% Or Greater Direct Ownership Interest Jul 7, 1966 100%
Ayub Ibrahim Individual Corporate Director Jul 1, 2009
W-2 Managing Employee Jul 1, 2009
Kenneth Edge Individual Corporate DirectorBoard Member Dec 4, 2000
Michael Nagowski Individual Corporate OfficerChief Executive Officer Jan 14, 2008
W-2 Managing EmployeeChief Executive Officer Jan 14, 2008
Christopher Aul Individual Corporate OfficerChief Medical Officer May 6, 2013
W-2 Managing EmployeeChief Medical Officer May 6, 2013
Joseph Fiser Individual Corporate OfficerVP Rev Cycle/Managed Care Planning Feb 9, 2022
W-2 Managing EmployeeVP Rev Cycle/Managed Care Feb 9, 2022
Charles Evans Individual Corporate DirectorBoard Member Dec 6, 2010
William Faircloth Individual Corporate DirectorBoard Member Dec 22, 2008
James Keefe Individual Corporate DirectorBoard Member Dec 22, 2008
Deborah Marshburn Individual W-2 Managing EmployeeVice President of Nursing Dec 13, 1982
Bradley J Broussard Individual Contracted Managing EmployeeBoard Member, Chief of Staff Oct 1, 2012
Corporate OfficerBoard Memeber, Chief of Staff Oct 1, 2012
Corporate DirectorBoard Member, Chief of Staff Oct 1, 2012

Owners & managing parties with NPI records 10

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

All facility ownership & control disclosures 14

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

FacilityTypeRoleSince
Cape Fear Valley-Bladen County HospitalElizabethtown, NC, CCN 341315 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jun 1, 2008
Jun 1, 2008
Cape Fear Valley - Bladen County HospitalElizabethtown, NC, CCN 34Z315 Hospital Operational/Managerial Control Jun 1, 2008
Cape Fear Valley Betsy Johnson HospitalDunn, NC, CCN 340071 Hospital 5% Or Greater Direct Ownership Interest (100%) Aug 31, 2021
Cape Fear Valley Hoke HospitalRaeford, NC, CCN 340188 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jun 11, 2009
Dec 1, 2014
Southeastern Regional Rehabilitation CenterFayetteville, NC, CCN 34T028 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 3, 2012
Cape Fear Valley Home HealthFayetteville, NC, CCN 347127 Home health agency 5% Or Greater Direct Ownership Interest (33%) Oct 1, 2008
Cape Fear Valley Hospice and Palliative CareFayetteville, NC, CCN 341562 Hospice 5% Or Greater Direct Ownership Interest (33%) Oct 1, 2008
Bladen Healthcare LLCDublin, NC, CCN 343444 Rural health clinic Operational/Managerial Control (100%) Aug 20, 2021
CFV Bma ElizabethtownElizabethtown, NC, CCN 343445 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2008
CFV Bma Express CareElizabethtown, NC, CCN 343449 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2008
Cape Fear Valley - Bladen Medical AssociatesBladenboro, NC, CCN 343446 Rural health clinic 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jun 1, 2008
Jun 1, 2008
Cape Fear Valley Bladen Medical AssociatesClarkton, NC, CCN 343464 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Apr 1, 2017
Apr 1, 2017
Cape Fear Valley Bladen Medical AssociatesElizabethtown, NC, CCN 343469 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 9, 2018
Jul 9, 2018
CFV Primary Care-Vineland Family MedicineWhiteville, NC, CCN 343477 Rural health clinic Operational/Managerial Control Oct 1, 2021

Owned or controlled facilities with NPI records 14

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

View all 14

Facilities with the same owner 14

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 14

Practitioners & affiliated clinicians

Affiliated clinicians 154

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

View all 154

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703548800000",
    "number": "1982607115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 788",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283020788",
            "telephone_number": "910-615-1000",
            "fax_number": "910-615-1046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 ROBESON ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283015570",
            "telephone_number": "910-615-1000",
            "fax_number": "910-615-1046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND COUNTY HOSPITAL SYSTEM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A",
        "authorized_official_last_name": "FISER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "BART",
        "authorized_official_title_or_position": "VP MANAGED CARE AND REVENUE CYCLE",
        "authorized_official_telephone_number": "910-615-5572",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NC",
            "license": "H0275",
            "primary": false
        },
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3402014",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Highsmith-Rainey Speciality Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Highsmith-Rainey Speciality Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.