ST PAUL HERMITAGE HOME (NPI# 1871605055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871605055 |
| Entity Type | Organization |
| Organization Name | ST PAUL HERMITAGE HOME |
| Practice Address |
501 N 17th Avenue Beech Grove IN 46107 |
| Practice Telephone | 3177862261 |
| Practice Fax Number | 3177821411 |
| Mailing Telephone | 3177862261 |
| Mailing Fax Number | 3177821411 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2008-06-17 |
| Authorized Official Name | MAUREEN THERESE COONEY (BOOKKEEPER) |
| Authorized Official Telephone | 3177862261 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 060003911 | IN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100274990A | 05 |
| Street Address |
501 N 17TH AVENUE |
| City | BEECH GROVE |
| State | IN |
| Zip Code | 46107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669757464 | Lisa Katherine Mabie | Pharmacist | 1808 N Albany St, Beech Grove, IN 46107 | 2011-10-13 |
| 1275797847 | Kay Lynn Kolthoff | Registered Nurse | 1600 Albany Street, Beech Grove, IN 46107 | 2008-07-14 |
| 1699802439 | James Michael Souers | Dentist | 4140 S Emerson Ave, Beech Grove, IN 46107 | 2007-02-28 |
| 1013931989 | David E. Crook | Anesthesiology | 1600 N. Albany St, Indianapolis, IN 46107 | 2006-07-26 |
| 1063409456 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 2002 Albany St, Beech Grove, IN 46107 | 2005-09-30 |
| 1629075429 | Victoria Ann Othersen | Family Medicine | 2030 Churchman Ave # A, Beech Grove, IN 46107 | 2005-07-07 |
| 1215548144 | Grace Connelly | Speech-Language Pathologist | 501 N 17th Ave, Beech Grove, IN 46107 | 2020-08-13 |
| 1780995969 | Sharon Sue Taylor | Nurse Practitioner | 2030 Churchman Ave Ste A, Beech Grove, IN 46107-1044 | 2010-06-23 |
| 1124012729 | Claudet C Smith | Internal Medicine | 2030 Churchman Ave, Beech Grove, IN 46107-1044 | 2005-09-09 |
| 1356825822 | Joseph Schnepp | Nurse Practitioner | 2030 Churchman Ave Ste A, Beech Grove, IN 46107-1044 | 2018-09-20 |
| Find all providers in zip 46107 | ||||
| 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 |
| Find all providers with the same taxonomy | ||||
| City | BEECH GROVE |
| Zip Code | 46107 |
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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.