FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC. (NPI# 1073582730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073582730 |
| Entity Type | Organization |
| Organization Name | FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC. |
| Other Organization Name | BROOKVILLE IMMEDIATE CARE |
| Practice Address |
11137 Us Highway 52 Suite A Brookville IN 47012 |
| Mailing Address |
1941 Virginia Ave Connersville IN 47331 |
| Practice Telephone | 7656475126 |
| Practice Fax Number | 7656475900 |
| Mailing Telephone | 7658255131 |
| Mailing Fax Number | 7658277796 |
| Enumeration Date | 2006-03-15 |
| 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 | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
050050591 | IN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2320330 | 05 | |
| IN | 200061320A | 05 |
| Other Name | Type Code |
|---|---|
| Brookville Immediate Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083719413 | Fayette Memorial Hospital Association Inc. | Specialist | 1941 Virginia Ave, Connersville, IN 47331-2833 | 2006-09-13 |
| 1518927128 | Fayette Memorial Hospital Association Inc. | Anesthesiology | 1941 Virginia Ave, Connersville, IN 47331-2833 | 2006-03-27 |
| 1508825720 | Fayette Memorial Hospital Association Inc. | General Acute Care Hospital | 1941 Virginia Ave, Connersville, IN 47331-2833 | 2006-03-18 |
| Street Address |
11137 US HIGHWAY 52 SUITE A |
| City | BROOKVILLE |
| State | IN |
| Zip Code | 47012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700441623 | Stephanie Rene Buckler | Developmental Therapist | 15106 State Road 1, Brookville, IN 47012 | 2019-05-06 |
| 1245777994 | Forefront Dermatology, S.c. | Dermatology | 11137 U.S. 52, Brookville, IN 47012 | 2017-01-19 |
| 1386006450 | Ashley Renee Sparks | Specialist/Technologist | 8158 Pea Ridge Rd, Brookville, IN 47012 | 2016-03-28 |
| 1639448665 | Joan Suding | Registered Nurse | 12163 St Peters Road, Brookville, IN 47012 | 2011-12-20 |
| 1992856686 | Nancy B Pieper | Counselor | 11137 Us Highway 52 Ste A, Brookville, IN 47012 | 2007-01-16 |
| 1225100258 | Jacob Andrew Giesting | Dentist | 10130 Oxford Pike, Brookville, IN 47012 | 2006-11-14 |
| 1013003524 | Oxford Pediatrics & Adolescents Inc | Pediatrics | 10058 Cooley Rd, Brookville, IN 47012 | 2006-10-04 |
| 1629433370 | Emily Striegler | Counselor | 9127 Oxford Pike, Brookville, IN 47012 | 2015-12-23 |
| 1629449004 | Allison M. Halcomb | Nurse Practitioner | 11137 Us Highway 52 Ste A, Brookville, IN 47012 | 2015-10-12 |
| 1134124290 | Daniel Paul Bukofchan | Chiropractor | 1235 Franklin Ave, Brookville, IN 47012-1037 | 2005-06-16 |
| Find all providers in zip 47012 | ||||
| Taxonomy Code | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154921294 | Midwest Express Care 4, LLC | Clinic/Center | 6131 Us Highway 6 Ste C, Portage, IN 46368-5058 | 2020-10-28 |
| 1093349540 | Heart of Families LLC | Clinic/Center | 10435 Woodfield Pl, Fort Wayne, IN 46835-9750 | 2020-02-24 |
| 1619536067 | Midwest Express Care 4 LLC | Clinic/Center | 5043 E 81st Ave, Merrillville, IN 46410-5912 | 2019-06-10 |
| 1053807990 | American Currenct Care P.a. | Clinic/Center | 4125 W Clara Ln, Muncie, IN 47304-5466 | 2018-07-03 |
| 1942796883 | American Currenct Care P.a. | Clinic/Center | 11580 Overlook Dr Ste 100, Fishers, IN 46037-4221 | 2018-07-03 |
| 1396231239 | American Currenct Care P.a. | Clinic/Center | 5603 W Raymond St Ste A-d, Indianapolis, IN 46241-4364 | 2018-07-03 |
| 1144716077 | American Currenct Care P.a. | Clinic/Center | 700 E Beardsley Ave Ste 100, Elkhart, IN 46514-3365 | 2018-07-03 |
| 1023504966 | American Currenct Care P.a. | Clinic/Center | 1311 N Shadeland Ave Ste E-j, Indianapolis, IN 46219-3660 | 2018-07-03 |
| 1922594860 | American Currenct Care P.a. | Clinic/Center | 4850 Century Plaza Rd Ste 100, Indianapolis, IN 46254-5477 | 2018-07-03 |
| 1780170621 | American Currenct Care P.a. | Clinic/Center | 7301 Georgetown Rd Ste 109-111, Indianapolis, IN 46268-5124 | 2018-07-03 |
| Find all providers with the same taxonomy | ||||
| City | BROOKVILLE |
| Zip Code | 47012 |
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.