ADAMS COUNTY MEMORIAL HOSPITAL (NPI# 1609977628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609977628 |
| Entity Type | Organization |
| Organization Name | ADAMS COUNTY MEMORIAL HOSPITAL |
| Other Organization Name | COURTYARD HEALTHCARE CENTER |
| Practice Address |
2400 College Avenue Goshen IN 46528 |
| Mailing Address |
Po Box 151 1100 Mercer Avenue Decatur IN 46733-2303 |
| Practice Telephone | 5745330351 |
| Practice Fax Number | 5745335714 |
| Mailing Telephone | 2607242145 |
| Mailing Fax Number | 2607283582 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2013-08-28 |
| Authorized Official Name | DANE WHEELER (CFO/TREASURER) |
| Authorized Official Telephone | 2607242145 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | Y |
| Parent Organization Name | ADAMS COUNTY MEMORIAL HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 000091 | IN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100290080 | 05 |
| Other Name | Type Code |
|---|---|
| Courtyard Healthcare Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891031480 | Adams County Memorial Hospital | Skilled Nursing Facility | 1350 West Main Street, Berne, IN 46711-1794 | 2012-12-31 |
| 1134493281 | Adams County Memorial Hospital | Nursing Facility/Intermediate Care Facility | 9802 Coldwater Road, Fort Wayne, IN 46825 | 2012-03-06 |
| 1982729604 | Adams County Memorial Hospital | Nursing Facility/Intermediate Care Facility | 6996 S Us 421, Versailles, IN 47042-9390 | 2007-03-20 |
| 1760519268 | Adams County Memorial Hospital | Skilled Nursing Facility | 12011 Whittern Rd, Monroeville, IN 46773-9126 | 2007-02-28 |
| 1356476154 | Adams County Memorial Hospital | Skilled Nursing Facility | 1300 Mercer Ave, Decatur, IN 46733-2407 | 2007-02-22 |
| 1477699460 | Adams County Memorial Hospital | Skilled Nursing Facility | 200 West Fourth Dtreet, Oaktown, IN 47561-8081 | 2007-01-29 |
| 1235205816 | Adams County Memorial Hospital | Skilled Nursing Facility | 520 W 9th Street, Jasper, IN 47546-2711 | 2006-11-27 |
| 1659454148 | Adams County Memorial Hospital | Skilled Nursing Facility | 9325 N. Crawford Streeet, Knightsville, IN 47857-0170 | 2006-10-20 |
| 1366531907 | Adams County Memorial Hospital | Assisted Living Facility | 400 Caylor Boulevard, Bluffton, IN 46714-8805 | 2006-10-12 |
| 1821185356 | Adams County Memorial Hospital | Skilled Nursing Facility | 17475 Dugdale Dr, South Bend, IN 46635-1545 | 2006-10-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ADAMS COUNTY MEMORIAL HOSPITAL | 1100 Mercer Ave, Decatur, IN 46733-2303 |
| Street Address |
2400 COLLEGE AVENUE |
| City | GOSHEN |
| State | IN |
| Zip Code | 46528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972981140 | Brett Dyer | Nurse Anesthetist, Certified Registered | 20208 Deer Path Ct., Goshen, IN 46528 | 2015-05-08 |
| 1831490275 | Renee Danielle Gilligan | Physical Therapy Assistant | 57078 Appaloosa Court, Goshen, IN 46528 | 2010-11-16 |
| 1760620090 | Lisa A Levin | Social Worker | 330 Lakeview Drive, Goshen, IN 46528 | 2009-01-23 |
| 1346319290 | Martin's Super Market | Pharmacy | 1527 Bashor Road, Goshen, IN 46528 | 2006-11-07 |
| 1336196591 | Carolin K. Marzouk | Nurse Practitioner | 213 Middlebury Street, Goshen, IN 46528 | 2006-05-31 |
| 1235185513 | Open and Wide Mri LLC | Radiology | 2856 Eisenhower Dr N., Suite 1, Goshen, IN 46528 | 2006-05-26 |
| 1407341233 | Leah Kathryn Richardson | Registered Nurse | 213 Middlebury St, Goshen, IN 46528 | 2018-06-25 |
| 1619324126 | Rebecca E Johnson | Registered Nurse | 808 N 3rd St, Goshen, IN 46528 | 2016-05-16 |
| 1861850695 | Gerardo Diaz | Nurse Practitioner | 808 N 3rd St, Goshen, IN 46528 | 2016-02-08 |
| 1508257619 | Holli Elizabeth Perrin | Behavioral Analyst | 203 N 5th St, Goshen, IN 46528 | 2015-02-11 |
| Find all providers in zip 46528 | ||||
| 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 |
|---|---|---|---|---|
| 1952812034 | Blue Diamond Villas | Skilled Nursing Facility | 1510 Sandpiper Lane, Goshen, IN 46526 | 2017-10-17 |
| 1093090730 | Wanda Bontrager | Skilled Nursing Facility | 404 Mount Vernon Dr, Goshen, IN 46526-1432 | 2011-10-13 |
| 1376608679 | Elant At Goshen, Inc. | Skilled Nursing Facility | 46 Harriman Drive, Goshen, NY 10924-2410 | 2006-12-27 |
| 1235294547 | Glen Arden, Inc. | Skilled Nursing Facility | 214 Harriman Drive, Goshen, NY 10924-2410 | 2006-12-27 |
| 1417991415 | Hancock Regional Hospital | Skilled Nursing Facility | 1332 Waterford Cir, Goshen, IN 46526-6009 | 2006-06-16 |
| 1154321669 | Americare Living of Goshen | Skilled Nursing Facility | 2400 College Ave, Goshen, IN 46528-5010 | 2005-07-26 |
| 1770586554 | Woodlawn Hospital | Skilled Nursing Facility | 1225 Greencroft Dr, Goshen, IN 46526-5102 | 2005-05-24 |
| 1720523954 | Goshen Operations LLC | Skilled Nursing Facility | 46 Harriman Dr, Goshen, NY 10924-2410 | 2016-12-26 |
| 1639479108 | Courtyard Rehabilitation Center, Inc | Skilled Nursing Facility | 2400 College Ave, Goshen, IN 46528-5010 | 2010-10-29 |
| 1164588315 | Lrc Management LLC, Dba The Courtyard of Goshen | Skilled Nursing Facility | 2400 College Ave, Goshen, IN 46528-5010 | 2006-12-29 |
| Find all providers in GOSHEN | ||||
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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.