FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC (NPI# 1053370270) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053370270 |
| Entity Type | Organization |
| Organization Name | FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC |
| Other Organization Name | FAYETTE REGIONAL CARE PAVILLION |
| Practice Address |
450 Erie Ave Connersville IN 47331-3176 |
| Mailing Address |
1941 Virginia Ave Connersville IN 47331-2833 |
| Practice Telephone | 7658277890 |
| Practice Fax Number | 7658256628 |
| Mailing Telephone | 7658278933 |
| Mailing Fax Number | 7658277863 |
| Enumeration Date | 2006-03-18 |
| Last Update Date | 2016-03-23 |
| Authorized Official Name | RANDALL WHITE (CEO) |
| Authorized Official Telephone | 7658277987 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | 7352421900926 | IN | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100415070A | 05 | |
| IN | 200406860A | 05 |
| Other Name | Type Code |
|---|---|
| Fayette Regional Care Pavillion | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750707964 | Fayette Memorial Hospital Association Inc | Clinic/Center | 2025 Virginia Ave, Connersville, IN 47331-2971 | 2014-03-12 |
| 1902125883 | Fayette Memorial Hospital Association Inc | Clinical Medical Laboratory | 1941 Virginia Ave, Connersville, IN 47331-2833 | 2010-05-18 |
| 1598724718 | Fayette Memorial Hospital Association Inc | Hospice Care, Community Based | 420 W 24th St, Connersville, IN 47331-2947 | 2006-03-18 |
| 1093774275 | Fayette Memorial Hospital Association Inc | Home Health | 1941 Virginia Ave, Connersville, IN 47331-2833 | 2006-03-17 |
| 1508835216 | Fayette Memorial Hospital Association Inc | Rehabilitation Unit | 1941 Virginia Ave, Connersville, IN 47331-2833 | 2006-03-15 |
| Street Address |
450 ERIE AVE |
| City | CONNERSVILLE |
| State | IN |
| Zip Code | 47331-3176 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932178712 | Kari L Byrd | Counselor | 450 Erie Ave, Connersville, IN 47331-3176 | 2006-03-15 |
| 1538679006 | Jessica Whited | Social Worker | 450 Erie Ave, Connersville, IN 47331-3176 | 2017-10-10 |
| 1184024515 | Dallas Holmes | Social Worker | 450 Erie Ave, Connersville, IN 47331-3176 | 2014-09-04 |
| 1407280449 | Tia R Bowling | Nurse Practitioner | 450 Erie Ave, Connersville, IN 47331-3176 | 2013-08-27 |
| 1487099115 | Fayette Memorial Hospital Association, Inc. | Psychiatric Hospital | 450 Erie Ave, Connersville, IN 47331-3176 | 2013-05-08 |
| 1689019051 | Renee Anne Telker | Registered Nurse | 450 Erie Ave, Connersville, IN 47331-3176 | 2013-04-30 |
| 1699079392 | Katrina Norris | Social Worker | 450 Erie Ave, Connersville, IN 47331-3176 | 2011-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275062630 | Williams Creek Health Center | Chiropractor | 685 S Co Rd 350 W, Connersville, IN 47331 | 2017-06-08 |
| 1801275201 | Americas Best Foot and Ankle Specialists | Podiatrist | 1475 East State Road 44 Suite 7., Whitewater Valley Medical Center, Connersville, IN 47331 | 2015-05-19 |
| 1508027269 | Kevin Andrew Yaryan | Optometrist | 522 N Eastern Ave, Connersville, IN 47331 | 2008-06-24 |
| 1477694602 | Residential Crf, Inc. | Intermediate Care Facility, Mentally Retarded | 556 S Co Rd 550 W, Connersville, IN 47331 | 2007-02-09 |
| 1316024904 | Mark Milton Wynn | Chiropractor | 208 W 20th St, Connersville, IN 47331 | 2006-11-01 |
| 1356368104 | Fayette County Government | Clinic/Center | 401 Central Ave, Connersville, IN 47331 | 2006-07-17 |
| 1760437818 | Karl Phillip Greene | Optometrist | 2045 Virginia Avenue, Connersville, IN 47331 | 2006-05-24 |
| 1225098825 | Fayette Memorial Hospital Assoc Inc | Clinic/Center | 3542 N Western Ave, Connersville, IN 47331 | 2006-03-27 |
| 1437118973 | Jereme Shawn Pflum | Chiropractor | 685 S. C.r. 350 W, Connersville, IN 47331 | 2006-03-22 |
| 1649279258 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 281 S County Road 200 E, Connersville, IN 47331 | 2005-07-15 |
| Find all providers in zip 47331 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831697598 | Indianapolis Vamc | Psychiatric Residential Treatment Facility | 9045 E 59th St Bldg 402, Indianapolis, IN 46216-1030 | 2018-01-29 |
| 1518382993 | Patrick Mcneill | Psychiatric Residential Treatment Facility | 614 Farley Dr, Indianapolis, IN 46214-3575 | 2014-02-21 |
| 1063561272 | Associates In Clinical Psychology PC | Psychiatric Residential Treatment Facility | 317 West Monroe St, Plymouth, IN 46563 | 2007-01-09 |
| 1134276884 | Youth Opportunity Center, Inc | Psychiatric Residential Treatment Facility | 3700 W Kilgore Ave, Muncie, IN 47304-4810 | 2007-01-04 |
| 1982774246 | Gibault, Inc. | Psychiatric Residential Treatment Facility | 6401 S Us Highway 41, Terre Haute, IN 47802-4749 | 2006-11-08 |
| 1801822440 | Hhc Indiana Inc. | Psychiatric Residential Treatment Facility | 1800 N Oak Dr, Plymouth, IN 46563-3406 | 2006-06-24 |
| 1275080400 | Shirley Mclean | Psychiatric Residential Treatment Facility | 1100 W 6th Ave, Gary, IN 46402-1711 | 2016-09-06 |
| 1770970337 | Crossroad Child and Family Services | Psychiatric Residential Treatment Facility | 2525 Lake Ave, Fort Wayne, IN 46805-5407 | 2015-04-22 |
| 1598194516 | Damar Services Inc. | Psychiatric Residential Treatment Facility | 6067 Decatur Blvd, Indianapolis, IN 46241-9606 | 2013-11-12 |
| 1730487901 | Gibault, Inc. | Psychiatric Residential Treatment Facility | 6401 S Us Highway 41, Terre Haute, IN 47802-4749 | 2011-03-11 |
| Find all providers with the same taxonomy | ||||
| City | CONNERSVILLE |
| Zip Code | 47331 |
Please comment or provide details below to improve the information on FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC.
| 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.