GRAYSON COUNTY HOSPITAL FOUNDATION INC (NPI# 1114929494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114929494 |
| Entity Type | Organization |
| Organization Name | GRAYSON COUNTY HOSPITAL FOUNDATION INC |
| Other Organization Name | TWIN LAKES REGIONAL MEDICAL CENTER |
| Practice Address |
910 Wallace Ave Leitchfield KY 42754-1418 |
| Practice Telephone | 2702599400 |
| Practice Fax Number | 2702599524 |
| Mailing Telephone | 2702599400 |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2019-02-19 |
| Authorized Official Name | CYNTHIA R BAILEY (REIMBURSEMENT ANALYST) |
| Authorized Official Telephone | 2702591656 |
| Is Organization Subpart | Y |
| Parent Organization Name | GRAYSON COUNTY HOSPITAL FOUNDATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2355S0801X |
Specialist/Technologist Specialization: Speech-Language Assistant |
Speech, Language and Hearing Service Providers | ||
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| Y | 282N00000X | General Acute Care Hospital | 100151 | KY | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 4500270600 | 05 | |
| KY | ANTHEM PROVIDER # | 000000054565 | 01 |
| KY | 01006733 | 05 | |
| KY | PASSPORT | 1048799 | 01 |
| KY | PASSPORT ADVANTAGE | 2432221000 | 01 |
| KY | 4588851800 | 05 |
| Other Name | Type Code |
|---|---|
| TWIN LAKES REGIONAL MEDICAL CENTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104454834 | Grayson County Hospital Foundation Inc | Obstetrics & Gynecology | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2020-03-30 |
| 1164054664 | Grayson County Hospital Foundation Inc | Clinic/Center | 301 Sunset Dr, Caneyville, KY 42721-9172 | 2020-02-12 |
| 1487767828 | Grayson County Hospital Foundation Inc | Clinical Medical Laboratory | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2006-08-17 |
| 1023010303 | Grayson County Hospital Foundation Inc | Medicare Defined Swing Bed Unit | 910 Wallace Ave, Leitchfield, KY 42754-1418 | 2005-06-01 |
| 1437152923 | Grayson County Hospital Foundation Inc | Emergency Medicine | 910 Wallace Ave, Leitchfield, KY 42754-1418 | 2005-05-27 |
| Street Address |
910 WALLACE AVE |
| City | LEITCHFIELD |
| State | KY |
| Zip Code | 42754-1418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538162268 | Joseph C Petrocelli | Surgery | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2005-05-27 |
| 1992306450 | Karen Michelle Manning | Nurse Practitioner | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2020-11-02 |
| 1104454834 | Grayson County Hospital Foundation Inc | Obstetrics & Gynecology | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2020-03-30 |
| 1649743667 | Concord Company of Tennessee Pllc | Physician Assistant | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2019-01-03 |
| 1891267290 | Kristen Russell | Nurse Practitioner | 910 Wallace Ave, Leitchfield, KY 42754 | 2018-12-23 |
| 1265900955 | Callie J Hancock | Nurse Anesthetist, Certified Registered | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2018-11-12 |
| 1568941987 | Robert Wayne Fuller | Physical Therapist | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2018-08-07 |
| 1114442324 | Jared Crocker | Nurse Anesthetist, Certified Registered | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2017-08-08 |
| 1518332691 | Eric Powell | Physical Therapist | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2015-12-01 |
| 1427434026 | Robert Holland | Nurse Anesthetist, Certified Registered | 910 Wallace Ave, Leitchfield, KY 42754 | 2015-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750816849 | April Braun | Occupational Therapy Assistant | 121 Byrtle Grove Rd, Leitchfield, KY 42754 | 2017-04-26 |
| 1124429766 | Scott Anthony Gibson | Counselor | 805 Commerce Dr, Leitchfield, KY 42754 | 2014-09-15 |
| 1013328137 | Sandra M Dennis | Counselor | 505 O Riley St, Leitchfield, KY 42754 | 2014-05-12 |
| 1699071258 | Ellen Renae Pharis | Massage Therapist | 205 Fraim St, Leitchfield, KY 42754 | 2011-01-31 |
| 1184664096 | Joseph Michael Harris Jr. | Physical Therapist | 201 South Main Street, Leitchfield, KY 42754 | 2006-06-08 |
| 1689611469 | Joseph Michael Mulligan | Nurse Anesthetist, Certified Registered | 515 Lake Front Rd., Leitchfield, KY 42754 | 2006-06-01 |
| 1407838030 | Lincoln Trail District Health Dept | Public Health or Welfare | 124 E White Oak St, Leitchfield, KY 42754 | 2005-11-18 |
| 1487646527 | Larry Brett Abney | Optometrist | 31 Bobby Bland Way, Leitchfield, KY 42754 | 2005-08-16 |
| 1336142025 | Ted B Rogers | Orthopaedic Surgery | 908 Wallace Ave, Leitchfield, KY 42754 | 2005-05-27 |
| 1912486887 | Jeanette Marie Jacobs | Pediatrics | 901 Wallace Ave, Leitchfield, KY 42754 | 2018-08-10 |
| Find all providers in zip 42754 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629433693 | Jewish Hospital and St. Mary's Healthcare, Inc. | General Acute Care Hospital | 3290 Dutchmans Lane, Louisville, KY 40207 | 2015-12-17 |
| 1295100113 | Jeffrey Joseph Curley | General Acute Care Hospital | 100 Academic Pkwy, Kcu Box 778, Grayson, KY 41143-2205 | 2015-12-03 |
| 1316296676 | St. Elizabeth Health Care | General Acute Care Hospital | 236 Wendel H Ford Blvd, Erlanger, KY 41018-1272 | 2012-09-02 |
| 1952623944 | Basem Attum | General Acute Care Hospital | 6315 Innisbrook Dr, Prospect, KY 40059-9285 | 2010-02-18 |
| 1376877555 | University of Kentucky Department of Radiology | General Acute Care Hospital | 740 S Limestone St Rm A125, Lexington, KY 40536-0001 | 2009-09-22 |
| 1073763801 | Jacalyn Vannessa Davis | General Acute Care Hospital | 709 E Madison St, Louisville, KY 40202-1629 | 2008-09-29 |
| 1972751469 | Mesa Medical Group | General Acute Care Hospital | 660 Irvin Rd, Danville, KY 40422-8897 | 2008-09-09 |
| 1821261967 | Ardenia Sanders-cleary | General Acute Care Hospital | 6880 Kentucky 3520, West Paducah, KY 42086-9531 | 2008-04-09 |
| 1427243880 | Bluegrass Speech Pathology,pllc | General Acute Care Hospital | 862 Cassidy Pike, Ewing, KY 41039 | 2007-09-10 |
| 1457553042 | Pattie A Clay Regional Medical Center | General Acute Care Hospital | 801 Eastern By-pass, Pharmacy Department, Richmond, KY 40475 | 2007-06-05 |
| Find all providers with the same taxonomy | ||||
| City | LEITCHFIELD |
| Zip Code | 42754 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.