NPIMap

Organization Active NPI

Grady Memorial Hospital Corporation

Doing business as Grady Health Systems

  • General Acute Care Hospital
  • Atlanta, GA
National Provider Identifier
1992799050
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
060069 Issued in GA
Legal business name
GRADY MEMORIAL HOSPITAL CORPORATION
Doing business as
Grady Health Systems
Practice address
80 Jesse Hill Jr Dr, SE
Atlanta, GA 30303-3050
Phone
(404) 616-1000
NPI assigned
Sep 6, 2005
Last updated
Jan 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Authorized official

Name
Mark Meyer
Title
Cfo
Phone
(404) 616-2315

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 060069 GA Primary
Rehabilitation Hospital 283X00000X
Land Ambulance 3416L0300X 060-30 GA

Addresses

Primary practice location

80 Jesse Hill Jr Dr, SE
Atlanta, GA 30303-3050

Mailing address

80 Jesse Hill Jr Drive, SE
Box 26019
Atlanta, GA 30303-3050
Phone (404) 616-6695

Other names 1

  • Grady Health Systems Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040614000100 GA Part B Supplier - Clinic/Group Practice 6406757590 Receives reassigned benefits from 10 practitioners
Practice locations: Atlanta, GA
O20080822000732 GA Part A Provider - Hospital 7517032998 Practice locations: Atlanta, GA; Union City, GA
O20240401000736 GA Part A Provider - Hospital 7517032998 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Atlanta, GA

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1992799050. Details of each certification follow.

Hospital certification: CCN 110079

Legal name
GRADY MEMORIAL HOSPITAL CORPORATION
Doing business as
GRADY HEALTH SYSTEM
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jan 31, 2025
Beds
953 (500 certified)
Ownership / control type
Private (not for profit)
Most recent change of ownership
Jun 1, 2008 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Dec 21, 2007 in GA
Enrollment address
80 Jesse Hill Jr Dr SE
Suite 2B034
Atlanta, GA 30303-3050
Main/Primary Hospital Location
Hospital subgroups
General, Acute care, Psychiatric unit

Hospital certification: CCN 11T079

Legal name
GRADY MEMORIAL HOSPITAL CORPORATION
Organization structure
CorporationNon-profit
Enrollment address
80 Jesse Hill Jr Dr SE
Unit 12 CD
Atlanta, GA 30303-3031
Hospital Rehabilitation Unit
Hospital subgroups
Acute care, Swing-bed approved, Psychiatric unit, Rehabilitation 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
Grady Memorial HospitalCCN 110079 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Grady Memorial HospitalCCN 11T079 · All quality measures
Ownership
Non-profit
Certified
May 15, 2024

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

2695 Buford Hwy NE
Atlanta, GA 30324
Phone (404) 616-6999

745 Memorial Dr SE
Atlanta, GA 30316
Phone (404) 616-3815

1964 Candler Rd
Decatur, GA 30032

1964 Candler Rd
Ste 1964
Decatur, GA 30032

1595 Cleveland Ave
East Point, GA 30344
Phone (404) 305-8086

1143 Alpharetta St
Roswell, GA 30075
Phone (404) 616-1550

2931 N Tenaya Way
Ste 204
Las Vegas, NV 89128
Phone (702) 233-2123

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Robert Sheft Individual Corporate DirectorBoard Member Mar 1, 2019
Shan Cooper Individual Corporate DirectorBoard Member Mar 1, 2021
Christine Guillory Individual Corporate OfficerSVP Chief Legal Officer Jan 12, 2026
W-2 Managing EmployeeSVP Chief Legal Officer Jan 12, 2026
Larry Gillerstedt Individual Corporate DirectorBoard Chair Mar 1, 2020
D'Andrea Morning Individual W-2 Managing EmployeeVP Compliance;Chief Compl Officer Sep 1, 2017
W-2 Managing EmployeeAd; Sep 1, 2017 100%
Operational/Managerial Control Sep 1, 2017 100%
Alicia M Ivey Individual Corporate DirectorBoard Member Mar 1, 2022
John W Hollins Individual Corporate DirectorBoard Member Mar 1, 2017
Eric V Thomas Individual Corporate DirectorBoard Member Mar 1, 2021
Bernard N Tokarz Individual Corporate DirectorBoard Member Mar 1, 2021
Pedro P Cherry Individual Corporate DirectorBoard Member Mar 1, 2021
John Gregg Individual Corporate DirectorBoard Member Mar 1, 2021
Timothy Jefferson Individual Corporate Officer Apr 22, 2008
W-2 Managing EmployeeSr. VP of Legal Affairs Jun 1, 1998
Corporate OfficerExecutive VP, General Counsel Apr 15, 2024
W-2 Managing EmployeeExecutive VP, General Counsel Apr 15, 2024
John Haupert Individual Corporate OfficerPresident/Ceo Oct 1, 2011
Rafael Garcia Individual W-2 Managing EmployeeDirector Jan 2, 2024

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Crestview Health & Rehabilitation CenterAtlanta, GA, CCN 115525 Skilled nursing facility Operational/Managerial Control Apr 22, 2008

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 618

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 618

Affiliated clinicians 1,313

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

View all 1,313

NPI Registry JSON

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1992799050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 JESSE HILL JR DRIVE, SE",
            "address_2": "BOX 26019",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033050",
            "telephone_number": "404-616-6695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 JESSE HILL JR DR, SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033050",
            "telephone_number": "404-616-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRADY MEMORIAL HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-06",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "404-616-2315"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "GA",
            "license": "060069",
            "primary": true
        },
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "GA",
            "license": "060-30",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grady Health Systems",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.