DECATUR COUNTY MEMORIAL HOSPITAL (NPI# 1487044822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487044822 |
| Entity Type | Organization |
| Organization Name | DECATUR COUNTY MEMORIAL HOSPITAL |
| Other Organization Name | BRIARCLIFF HEALTH & REHABILITATION CENTER |
| Practice Address |
5024 W Western Ave South Bend IN 46619-2312 |
| Practice Telephone | 5743405022 |
| Mailing Telephone | 5743405022 |
| Enumeration Date | 2015-01-23 |
| Last Update Date | 2016-04-06 |
| Authorized Official Name | MR. RICHARD KENNEDY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5743405022 |
| Authorized Official Credential | HFA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200808300A | 05 |
| Other Name | Type Code |
|---|---|
| Briarcliff Health & Rehabilitation Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629698808 | Decatur County Memorial Hospital | Skilled Nursing Facility | 6712 Restoracy Drive, Whitestown, IN 46075-0089 | 2020-04-17 |
| 1275001489 | Decatur County Memorial Hospital | Clinic/Center | 955 N Michigan Ave Ste 2, Greensburg, IN 47240-1487 | 2018-11-06 |
| 1821512138 | Decatur County Memorial Hospital | Surgery | 731 N Lincoln St, Greensburg, IN 47240-1328 | 2017-07-28 |
| 1164599304 | Decatur County Memorial Hospital | Alzheimer Center (Dementia Center) | 18325 Bailey Ave, South Bend, IN 46637 | 2006-11-30 |
| 1346292737 | Decatur County Memorial Hospital | Skilled Nursing Facility | 353 Tyler Street, Gary, IN 46402-1149 | 2006-05-16 |
| 1295720365 | Decatur County Memorial Hospital | Skilled Nursing Facility | 950 N Lakeview Dr, Greensburg, IN 47240-3405 | 2005-09-15 |
| 1952300477 | Decatur County Memorial Hospital | General Acute Care Hospital | 720 N. Lincoln St, Greensburg, IN 47240-1398 | 2005-07-18 |
| 1295732188 | Decatur County Memorial Hospital | Clinic/Center | 718 N. Lincoln St, Greensburg, IN 47240-1348 | 2005-07-07 |
| 1124025010 | Decatur County Memorial Hospital | Home Health | 955 N. Michigan St., Greensburg, IN 47240-1327 | 2005-07-07 |
| 1629588181 | Decatur County Memorial Hospital | Nursing Facility/Intermediate Care Facility | 3640 Central Ave, Indianapolis, IN 46205-3569 | 2017-10-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DECATUR COUNTY MEMORIAL HOSPITAL | 720 N Lincoln St, Greensburg, IN 47240-1327 |
| Indiana Business Entities | DECATUR COUNTY MEMORIAL HOSPITAL | Formed Pursuant To Ic 16-22-8-6, "other Entity" Under 23-15-1-5-, To Provide for Assumed Name, ., |
| Street Address |
5024 W WESTERN AVE |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46619-2312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396873147 | Barbara Lynn Miller | Counselor | 5024 W Western Ave, South Bend, IN 46619-2312 | 2007-03-02 |
| 1326672262 | Ronnae Tessely | Occupational Therapist | 5024 W Western Ave, South Bend, IN 46619-2312 | 2020-03-01 |
| 1760029508 | Vipul B Patel | Physical Therapy Assistant | 5024 W Western Ave, South Bend, IN 46619-2312 | 2019-11-27 |
| 1124156971 | Zaid Hawa | Counselor | 5024 W Western Ave, South Bend, IN 46619-2312 | 2007-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578015103 | Martin's Super Markets, Inc. | Pharmacy | 525 S. Mayflower Rd, South Bend, IN 46619 | 2016-10-31 |
| 1124449053 | Sandra J Jackson | Counselor | 4218 Western Ave., South Bend, IN 46619 | 2013-12-19 |
| 1902227911 | Patricia Ann Miller | Counselor | 4218 Western Ave, South Bend, IN 46619 | 2013-12-17 |
| 1740611953 | Cynthia G. Finney | Counselor | 4218 Western Avenue, So Bend, IN 46619 | 2013-12-13 |
| 1437433406 | Angela Nicole Zolvinski | Pharmacist | 4444 W. Western Ave, South Bend, IN 46619 | 2011-10-07 |
| 1871674556 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 4600 W Washington St, South Bend, IN 46619 | 2006-10-18 |
| 1942302203 | April Holtgren | Family Medicine | 1901 #b Western Ave, South Bend, IN 46619 | 2006-09-05 |
| 1447737002 | Graciela Jimenez-martinez | Registered Nurse | 1901 #b Western Avenue, South Bend, IN 46619 | 2018-07-25 |
| 1821397878 | Wright Dream | In Home Supportive Care | 706 S Sheridan St, South Bend, IN 46619 | 2011-03-16 |
| 1740439223 | Scott J. Vanslambrouck | Dentist | 1901 #b Western Avenue, Ihc South Bend, South Bend, IN 46619 | 2008-09-09 |
| Find all providers in zip 46619 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821427857 | Hancock Regional Hospital | Skilled Nursing Facility | 52565 Sr 933, South Bend, IN 46637 | 2013-11-12 |
| 1295064525 | Starlight Care Facilities, Inc | Skilled Nursing Facility | 915 So. 27th Street, South Bend, IN 46615 | 2009-12-16 |
| 1669544516 | Indiana Health and Rehabilitation Centers | Skilled Nursing Facility | 1950 Ridgedale Rd, South Bend, IN 46614-2243 | 2006-11-15 |
| 1871674556 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 4600 W Washington St, South Bend, IN 46619 | 2006-10-18 |
| 1235219148 | Janeczko Properties LLC | Skilled Nursing Facility | 206 E Marion St, South Bend, IN 46601-1029 | 2006-10-16 |
| 1821185356 | Adams County Memorial Hospital | Skilled Nursing Facility | 17475 Dugdale Dr, South Bend, IN 46635-1545 | 2006-10-06 |
| 1093750119 | St. Clair Darden Health System Inc | Skilled Nursing Facility | 20531 Darden Rd, South Bend, IN 46637-2915 | 2006-06-20 |
| 1841287232 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 1121 E Lasalle Ave, South Bend, IN 46617 | 2005-09-30 |
| 1477913754 | Chalet of Hastings LLC | Skilled Nursing Facility | 6101 Nimtz Pkwy, South Bend, IN 46628-6111 | 2016-03-01 |
| 1194167650 | Pulaski Memorial Hospital | Skilled Nursing Facility | 206 E Marion St, South Bend, IN 46601-1029 | 2013-07-25 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46619 |
Please comment or provide details below to improve the information on DECATUR COUNTY MEMORIAL HOSPITAL.
| 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.