JOHNSON MEMORIAL HOSPITAL (NPI# 1003838194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003838194 |
| Entity Type | Organization |
| Organization Name | JOHNSON MEMORIAL HOSPITAL |
| Other Organization Name | MILLER'S MERRY MANOR |
| Practice Address |
505 West Wolfe Street Sullivan IN 47882 |
| Mailing Address |
1125 W Jefferson St Franklin IN 46131-2140 |
| Practice Telephone | 8122686361 |
| Practice Fax Number | 8122684454 |
| Mailing Telephone | 3177367549 |
| Mailing Fax Number | 3177362692 |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2020-04-21 |
| Authorized Official Name | MR. ADAM PUTVIN (CFO) |
| Authorized Official Telephone | 3173467939 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BN1400X |
Durable Medical Equipment & Medical Supplies Specialization: Nursing Facility Supplies |
Suppliers | ||
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
IN | Suppliers | |
| Y | 314000000X | Skilled Nursing Facility | 06-000163-1 | IN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100291380A | 05 |
| Other Name | Type Code |
|---|---|
| Miller's Merry Manor | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487016549 | Johnson Memorial Hospital | General Acute Care Hospital | 214 Crenshaw Dr, Saint Paul, IN 47272-9435 | 2016-03-27 |
| 1144627977 | Johnson Memorial Hospital | Skilled Nursing Facility | 411 N Wolf Rd, Columbia City, IN 46725-8733 | 2014-11-21 |
| 1881001527 | Johnson Memorial Hospital | Skilled Nursing Facility | 3530 Monroe Street, La Porte, IN 46350 | 2014-07-15 |
| 1144236415 | Johnson Memorial Hospital | Durable Medical Equipment & Medical Supplies | 1720 Alber St, Wabash, IN 46992-1015 | 2006-07-31 |
| 1982627329 | Johnson Memorial Hospital | Durable Medical Equipment & Medical Supplies | 200 26th St, Logansport, IN 46947-2063 | 2006-07-26 |
| 1508889940 | Johnson Memorial Hospital | Durable Medical Equipment & Medical Supplies | 548 S 100 W, Hartford City, IN 47348-9507 | 2006-07-26 |
| 1669495008 | Johnson Memorial Hospital | Durable Medical Equipment & Medical Supplies | 5909 Lute Rd, Portage, IN 46368-4824 | 2006-07-26 |
| 1134142573 | Johnson Memorial Hospital | Durable Medical Equipment & Medical Supplies | 612 E 11th St, Rushville, IN 46173-1319 | 2006-07-26 |
| 1437172871 | Johnson Memorial Hospital | Durable Medical Equipment & Medical Supplies | 2901 W 37th Ave, Hobart, IN 46342-1727 | 2006-07-26 |
| 1952324394 | Johnson Memorial Hospital | Durable Medical Equipment & Medical Supplies | 524 Anderson Rd, Chesterfield, IN 46017-1514 | 2006-07-26 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | JOHNSON MEMORIAL HOSPITAL | 1125 W Jefferson St, Franklin, IN 46131-2140 |
| Connecticut Business Registrations | Johnson Memorial Hospital Auxiliary, Inc. | One Financial Plaza, Hartford, CT 06103 |
| Connecticut Business Registrations | JOHNSON MEMORIAL HOSPITAL, INC. | 201 Chestnut Hill Road, Stafford Springs, CT 06076 |
| Street Address |
505 WEST WOLFE STREET |
| City | SULLIVAN |
| State | IN |
| Zip Code | 47882 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659718336 | Neil Lynn Smith | Dentist | 118 S. Court St., Sullivan, IN 47882 | 2013-06-04 |
| 1184888000 | Mary Sherman Hospital | Hospice Care, Community Based | 817 North Section Street, Suite A, Sullivan, IN 47882 | 2008-07-10 |
| 1255580593 | Daniel Choyce Callahan | Psychiatry & Neurology | 2204 N Section St, Sullivan, IN 47882 | 2008-09-11 |
| 1851394175 | Van Evanoff Jr. | Pain Medicine | 2204 N Section St, Suite B, Sullivan, IN 47882-0010 | 2005-05-31 |
| 1982780748 | Associated Physicians & Surgeons Clinic, LLC | Obstetrics & Gynecology | 2204 N Section St, Suite B, Sullivan, IN 47882-0010 | 2006-10-27 |
| 1871996199 | Sullivan Family Dentistry, LLC | Dentist | 2186 N Hospital Blvd., Suite 1, Sullivan, IN 47882-0468 | 2014-10-01 |
| 1487828455 | Kortni Reann Martindale | Speech-Language Pathologist | 368 W Indiana Ave, Sullivan, IN 47882-1117 | 2008-04-21 |
| 1831280585 | Southwest School Corporation | Local Education Agency (LEA) | 110 N Main St, Sullivan, IN 47882-1225 | 2006-09-27 |
| 1780717637 | Brian K Grindstaff | Chiropractor | 210 N Section St Unit C, Sullivan, IN 47882-1237 | 2007-03-13 |
| 1700854072 | Sullivan Surgicenter,llc | Clinic/Center | 320 N Section St, Sullivan, IN 47882-1239 | 2006-03-10 |
| Find all providers in zip 47882 | ||||
| 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 |
|---|---|---|---|---|
| 1568419232 | Sullivan Operations, LLC | Skilled Nursing Facility | 875 Dunsford Dr, Sullivan, MO 63080-1238 | 2006-05-28 |
| 1417913583 | Sullivan Hco, LLC | Skilled Nursing Facility | 11 Hawthorne Ln, Sullivan, IL 61951-9490 | 2006-04-26 |
| 1710952866 | Sullivan Health & Living Center, Inc. | Skilled Nursing Facility | 325 W Northwood Dr, Sullivan, IN 47882-7515 | 2006-02-22 |
| 1194703702 | Petersen Health Care Vii LLC | Skilled Nursing Facility | 1 Masonic Way, Sullivan, IL 61951-9467 | 2006-01-04 |
| 1811984644 | Eastview Terrace | Skilled Nursing Facility | 100 Eastview Pl, Sullivan, IL 61951-1674 | 2005-10-06 |
| 1063419505 | Community Care Ctr of Sullivan, Inc | Skilled Nursing Facility | 940 Mattox Dr, Sullivan, MO 63080-2364 | 2005-06-30 |
| 1063045227 | Eastview Hco, LLC | Skilled Nursing Facility | 100 Eastview Pl, Sullivan, IL 61951-1674 | 2020-02-17 |
| 1386277556 | Sullivan Hco, LLC | Skilled Nursing Facility | 11 Hawthorne Ln, Sullivan, IL 61951-9490 | 2020-02-17 |
| 1609027846 | Petersen Health Care, Inc | Skilled Nursing Facility | 100 Eastview Pl, Sullivan, IL 61951-1674 | 2008-10-07 |
| 1376794511 | Petersen Health Care II, Inc. | Skilled Nursing Facility | 11 Hawthorne Ln, Sullivan, IL 61951-9490 | 2008-10-07 |
| Find all providers in SULLIVAN | ||||
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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.