MR. JACK J HUGHES III (NPI# 1528309267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528309267 |
| Entity Type | Individual |
| Full Name | MR. JACK J HUGHES III |
| Credential | COTA |
| Practice Address |
1850 W Matador St Peru IN 46970-3711 |
| Mailing Address |
4476 N 622 W Huntington IN 46750-8984 |
| Practice Telephone | 7656895000 |
| Mailing Telephone | 2603588827 |
| Enumeration Date | 2013-03-05 |
| Last Update Date | 2013-03-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 32002213A | IN | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528162674 | Jack Lindley Hughes | Ophthalmology | 2500 N Mayfair Rd, Ste 200, Milwaukee, WI 53226-1415 | 2006-09-11 |
| Street Address |
1850 W MATADOR ST |
| City | PERU |
| State | IN |
| Zip Code | 46970-3711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114930104 | Major Hospital | Skilled Nursing Facility | 1850 W Matador St, Peru, IN 46970-3711 | 2006-08-14 |
| 1497186597 | Joline Alexander | Speech-Language Pathologist | 1850 W Matador St, Peru, IN 46970-3711 | 2013-11-29 |
| 1295051019 | Nicole Rae Burkhart | Occupational Therapy Assistant | 1850 W Matador St, Peru, IN 46970-3711 | 2010-04-19 |
| 1093920563 | Marikay Boylan | Occupational Therapy Assistant | 1850 W Matador St, Peru, IN 46970-3711 | 2007-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447896311 | Christina M Van Meter | Pharmacist | 930 W Main St., Peru, IN 46970 | 2019-11-26 |
| 1821554585 | Thomas Gilbert Reaves | Counselor | 5851 S. Us-31, Lot 47, Peru, IN 46970 | 2019-02-18 |
| 1104154863 | American Foot and Ankle Inc | Durable Medical Equipment & Medical Supplies | 632 West Main Street, Peru, IN 46970 | 2009-11-18 |
| 1629208251 | Rafik Farag | Family Medicine | 1694 W Logansport Rd., Community Health Center of Miami County, Peru, IN 46970 | 2009-07-16 |
| 1508076050 | Peggy L Wert | Occupational Therapy Assistant | 850 Matador Drive, Peru, IN 46970 | 2007-05-23 |
| 1972690634 | Sherif Elmasry | Pediatrics | 655 N Broadway, Peru, IN 46970 | 2006-10-06 |
| 1548357320 | Belinda Diane Stonger | Hearing Instrument Specialist | 1 S. Broadway, Peru, IN 46970 | 2006-10-05 |
| 1134214083 | American Health Network of Indiana, LLC | Durable Medical Equipment & Medical Supplies | 315 West Old Key Drive, Peru, IN 46970 | 2006-10-04 |
| 1710082409 | Thomas J Guthrie | Dentist | 5 West Logan Street, Peru, IN 46970 | 2006-09-14 |
| 1750921938 | Christina Russell | Counselor | 1000 N Broadway Ste A, Peru, IN 46970 | 2020-01-15 |
| Find all providers in zip 46970 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871040659 | Stephanie Hentrup | Nursing Facility/Intermediate Care Facility | 621 E 20th St, Ferdinand, IN 47532-9220 | 2016-09-08 |
| 1912354630 | Denise Chambery | Nursing Facility/Intermediate Care Facility | 5707 W 122nd Pl, Crown Point, IN 46307-8778 | 2016-05-23 |
| 1124494760 | Maplemanor Christian Home, Inc. | Nursing Facility/Intermediate Care Facility | 643 W Utica St, Sellersburg, IN 47172-1163 | 2015-08-18 |
| 1174868822 | Daviess County Hospital | Nursing Facility/Intermediate Care Facility | 120 East Miller Drive, Bloomington, IN 47407-6538 | 2012-12-06 |
| 1134493281 | Adams County Memorial Hospital | Nursing Facility/Intermediate Care Facility | 9802 Coldwater Road, Fort Wayne, IN 46825 | 2012-03-06 |
| 1447481049 | Larry Wayne Sims | Nursing Facility/Intermediate Care Facility | 1236 Lincoln Ave, Evansville, IN 47714-1056 | 2009-07-30 |
| 1720253313 | Davis Elderly Care, LLC | Nursing Facility/Intermediate Care Facility | 5139 S Hanover Saluda Rd, Hanover, IN 47243-9212 | 2008-04-24 |
| 1750585766 | Gosport Care, Inc. | Nursing Facility/Intermediate Care Facility | 27 S. 7th St., Gosport, IN 47433-0099 | 2007-06-13 |
| 1790986792 | Evansville Protestant Home Inc. | Nursing Facility/Intermediate Care Facility | 3701 Washington Ave, Evansville, IN 47714-0544 | 2007-05-29 |
| 1881816148 | Pulaski Memorial Hospital | Nursing Facility/Intermediate Care Facility | 505 North Gavin Street, Muncie, IN 47303 | 2007-05-03 |
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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.