Caldwell County Hospital Inc

Organization Active NPI Rural Health Clinic/Center · Princeton, KY

NPI 1992268247 · NPPES record last updated Sep 4, 2025

Key facts

NPI
1992268247
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
CALDWELL COUNTY HOSPITAL INC
Practice address
320 Micbeth Dr
Princeton, KY 42445-6332
Phone
(270) 365-0320
Fax
(270) 365-4152
NPI assigned
Apr 12, 2019
Organization subpart
No

Authorized official

Name
Teresa L. Carpenter
Title
Director
Phone
(270) 365-0238

Owners & managing parties with NPI records 1

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

Other NPIs with the same Medicare PAC ID 6

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

Corporate family (same tax ID) 6

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

Facilities connected through Provider of Services related, parent or unit certification numbers.

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2131272Caldwell Medical Associates
320 Micbeth Drive, Princeton, KY 42445
Certificate of waiverMay 24, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KY

Rural health clinic certification: CCN 188526

Legal name
CALDWELL COUNTY HOSPITAL, INC
Doing business as
CALDWELL MEDICAL ASSOCIATES
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 30, 2019
Last certification
Aug 30, 2019
Ownership / control type
2B
Organization structure
Corporation · Non-profit
Incorporated
Nov 25, 1952 in KY
Enrollment address
320 Micbeth Dr
Princeton, KY 42445-6332
Related CCNs
181322

All disclosed owners & managing parties 12

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

NameRoleSinceShare
David Lee Oliver
Individual
Corporate Officer
Secretary
May 1, 2019
Nacy Elizabeth Butts
Individual
Corporate Officer
Cfo
May 1, 2019
Corporate Director
Cfo
May 1, 2019
W-2 Managing Employee
Cfo
May 1, 2019
Charles Littlejohn
Individual
Corporate Officer
Chairman
May 1, 2019
Joseph Falder
Individual
Corporate Officer
Vice Chairman
May 1, 2019
Harold D Odegaard
Individual
Corporate Officer
Ceo
May 1, 2019
Corporate Director
Ceo
May 1, 2019
W-2 Managing Employee
Ceo
May 1, 2019
Monte Nesmith
Individual
Corporate Officer
Member
May 1, 2019
Martiza C Stallins
Individual
Corporate Officer
Member
May 1, 2019
Ellen Dunning
Individual
Corporate Officer
Judge Executive
May 1, 2019
Patricia Lander
Individual
Corporate Officer
Chairman
May 1, 2019
John Bugg
Individual
Corporate Officer
Board Member
Apr 15, 2019
Joseph Gray
Individual
Corporate Officer
Committee
May 1, 2019
Steve Woodward
Individual
Corporate Officer
Member
May 1, 2019

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20190517000413 KY Part a Provider - Rural Health Clinic 0749275014 Practice locations: Princeton, KY

National Provider Directory

Tax ID family
R Wayne Hodge MD (7 organizations share this tax ID)

Locations

302 Micbeth Dr
Princeton, KY 42445
Phone (270) 365-1225

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X
Rural Health Clinic/Center 261QR1300X Yes

Addresses

Primary practice location

320 Micbeth Dr
Princeton, KY 42445-6332

Mailing address

PO Box 410
Princeton, KY 42445-0410
Phone (270) 365-0320

Other names

  • Caldwell Medical Associates Doing business as

Other providers in Princeton, KY

All providers in Princeton, KY · Rural Health Clinic/Center in Kentucky

Sources for this page

Verify at the official NPI Registry.