JASPER COUNTY HOSPITAL (NPI# 1114982253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114982253 |
| Entity Type | Organization |
| Organization Name | JASPER COUNTY HOSPITAL |
| Other Organization Name | BROOK HEALTH CENTRE |
| Practice Address |
420 E Main St Brook IN 47922-8715 |
| Mailing Address |
1104 E Grace St Rensselaer IN 47978-3211 |
| Practice Telephone | 2192752521 |
| Practice Fax Number | 2192759342 |
| Mailing Telephone | 2198665141 |
| Mailing Fax Number | 2198663234 |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2015-06-16 |
| Authorized Official Name | JEFFREY D WEBB (VP FINANCIAL SERVICES) |
| Authorized Official Telephone | 2198665141 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
71000809A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100187080A | 05 |
| Other Name | Type Code |
|---|---|
| Brook Health Centre | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982930483 | Jasper County Hospital | Non-Pharmacy Dispensing Site | 520 S Halleck Street, Demotte, IN 46310-8630 | 2009-10-19 |
| 1457317786 | Jasper County Hospital | Nurse Practitioner | 492 S Bierma St, Wheatfield, IN 46392 | 2006-04-25 |
| 1811962228 | Jasper County Hospital | General Acute Care Hospital | 1104 E Grace St, Rensselaer, IN 47978-3211 | 2006-02-20 |
| 1336306364 | Jasper County Hospital | General Acute Care Hospital | 1104 E Grace St, Rensselaer, IN 47978-3296 | 2008-05-19 |
| 1871750802 | Jasper County Hospital | General Acute Care Hospital | 1104 E Grace St, Rensselaer, IN 47978-3296 | 2008-05-19 |
| 1417029315 | Jasper County Hospital | General Acute Care Hospital | 1104 E Grace St, Rensselaer, IN 47978-3211 | 2006-11-15 |
| 1730147141 | Jasper County Hospital | Hospice Care, Community Based | 1104 E Grace St, Rensselaer, IN 47978-3211 | 2006-05-03 |
| 1902864325 | Jasper County Hospital | Non-Pharmacy Dispensing Site | 1104 E Grace St, Rensselaer, IN 47978-3211 | 2006-05-03 |
| 1801853023 | Jasper County Hospital | Home Health | 1104 E Grace St, Rensselaer, IN 47978-3211 | 2006-05-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | JASPER COUNTY HOSPITAL | Formed Pursuant To Ic 16-22-8-6, "other Entity" Under 23-15-1-5-, To Provide for Assumed Name, ., IN |
| Street Address |
420 E MAIN ST |
| City | BROOK |
| State | IN |
| Zip Code | 47922-8715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710367966 | Franciscan Health Rensselaer, Inc. | Nurse Practitioner | 420 E Main St, Brook, IN 47922-8715 | 2015-06-03 |
| 1407812902 | Catherine J Larson | Nurse Practitioner | 420 E Main St, Brook, IN 47922-8715 | 2006-04-24 |
| 1619969961 | Marianne Nelson | Family Medicine | 420 E Main St, Brook, IN 47922-8715 | 2005-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811086044 | Board of Commissioners of Newton County | Skilled Nursing Facility | 3623 E State Road 16, Brook, IN 47922-8800 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811086044 | Board of Commissioners of Newton County | Skilled Nursing Facility | 3623 E State Road 16, Brook, IN 47922-8800 | 2006-10-12 |
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710367966 | Franciscan Health Rensselaer, Inc. | Nurse Practitioner | 420 E Main St, Brook, IN 47922-8715 | 2015-06-03 |
| 1407812902 | Catherine J Larson | Nurse Practitioner | 420 E Main St, Brook, IN 47922-8715 | 2006-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386244176 | Mallory Lee Anslow | Nurse Practitioner | 10641 Deercrest Ln, Indianapolis, IN 46239-9690 | 2020-10-29 |
| 1285234237 | Vb Medical Group LLC | Nurse Practitioner | 10047 Whispering Wind Dr, Greenville, IN 47124-9704 | 2020-10-29 |
| 1518566397 | Stacey Renee Pulver | Nurse Practitioner | 13134 Hollow Oak Rd, Fort Wayne, IN 46845-2327 | 2020-10-22 |
| 1578162459 | Kourtney Marie Terry | Nurse Practitioner | 128 Miner Rd, Avilla, IN 46710-9690 | 2020-10-21 |
| 1780283630 | Dana L Yergler | Nurse Practitioner | 16632 Linfield Ct, Granger, IN 46530-7012 | 2020-10-21 |
| 1730788720 | Camille Mae Carl | Nurse Practitioner | 6441 Anna Louise Dr, Charlestown, IN 47111-8797 | 2020-10-20 |
| 1124626585 | Dustin Mikesell | Nurse Practitioner | 1000 E Main St Ste 104, Danville, IN 46122-1948 | 2020-10-16 |
| 1144828799 | Mina Desai-patel | Nurse Practitioner | 14698 Drayton Dr, Noblesville, IN 46062-8230 | 2020-10-15 |
| 1649878554 | Heather Ormiston-leclear | Nurse Practitioner | 3800 N Anthony Blvd # Cc1335, Fort Wayne, IN 46805-1430 | 2020-10-13 |
| 1023616125 | Kimberly Dawn Calloway | Nurse Practitioner | 5306 E Blocher Rd, Lexington, IN 47138-8803 | 2020-10-12 |
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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.