PULASKI MEMORIAL HOSPITAL (NPI# 1306837869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306837869 |
| Entity Type | Organization |
| Organization Name | PULASKI MEMORIAL HOSPITAL |
| Other Organization Name | NORTHERN LAKES NURSING & REHAB CENTER |
| Practice Address |
516 Williams St Angola IN 46703-1144 |
| Practice Telephone | 2606659467 |
| Practice Fax Number | 2606242297 |
| Mailing Telephone | 2606659467 |
| Mailing Fax Number | 2606242297 |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2018-02-26 |
| Authorized Official Name | LISA BAKER (CORP OPERATIONS MANAGER) |
| Authorized Official Telephone | 8127489155 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 050004261 | IN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100275480 | 05 |
| Other Name | Type Code |
|---|---|
| Northern Lakes Nursing & Rehab Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336548353 | Pulaski Memorial Hospital | Skilled Nursing Facility | 6050 S Cr 800 E-92, Fort Wayne, IN 46814-9201 | 2014-08-14 |
| 1801205240 | Pulaski Memorial Hospital | Assisted Living Facility | 5250 Heritage Pkwy, Fort Wayne, IN 46835-1061 | 2014-08-11 |
| 1881816148 | Pulaski Memorial Hospital | Nursing Facility/Intermediate Care Facility | 505 North Gavin Street, Muncie, IN 47303 | 2007-05-03 |
| 1346263217 | Pulaski Memorial Hospital | Nursing Facility/Intermediate Care Facility | 700 E 21st Ave, Gary, IN 46407 | 2006-07-25 |
| 1710930524 | Pulaski Memorial Hospital | Skilled Nursing Facility | 624 E 13th St, Winamac, IN 46996-1117 | 2006-05-19 |
| 1811987894 | Pulaski Memorial Hospital | Skilled Nursing Facility | 643 West Utica Street, Sellersburg, IN 47172-1163 | 2005-10-21 |
| 1932196177 | Pulaski Memorial Hospital | Skilled Nursing Facility | 1010 W Washington Center Rd, Ft Wayne, IN 46825-4155 | 2005-10-03 |
| 1376540310 | Pulaski Memorial Hospital | Home Health | 616 E. 13th Street, Winamac, IN 46996-1117 | 2005-07-06 |
| 1346245271 | Pulaski Memorial Hospital | Nursing Facility/Intermediate Care Facility | 801 Huntington Ave, Warren, IN 46792-9402 | 2005-06-16 |
| 1477556546 | Pulaski Memorial Hospital | Nursing Facility/Intermediate Care Facility | 1180 W 500 N, Huntington, IN 46750-1661 | 2005-05-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PULASKI MEMORIAL HOSPITAL | 616 E 13th St, Winamac, IN 46996-1117 |
| Street Address |
516 WILLIAMS ST |
| City | ANGOLA |
| State | IN |
| Zip Code | 46703-1144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629617097 | Carolyn Yvonne Davis | Registered Nurse | 909b South Darling Street, Angola, IN 46703 | 2020-01-02 |
| 1588144760 | Travis William Simmons | Chiropractor | 1220 N 200 W, Angola, IN 46703 | 2018-08-17 |
| 1386025427 | Jessica Conrad | Physical Therapist | 1913 North Wayne St, Suite D, Angola, IN 46703 | 2015-06-15 |
| 1578977385 | Amber Joy Richards | Counselor | 200 Hoosier Dr. Suite E, Angola, IN 46703 | 2014-06-19 |
| 1972874667 | Amanda Louise Traxler | Specialist/Technologist | 350 S John Mcbride Ave, Angola, IN 46703 | 2012-01-26 |
| 1659656155 | Kelly Balyeat | Pharmacist | 2012 North Wayne Street, Angola, IN 46703 | 2011-10-15 |
| 1689843930 | Erin Nicole Culler | Pharmacist | 2290 North Wayne Street, Angola, IN 46703 | 2008-02-20 |
| 1235319963 | J Andrew Stoner | Counselor | 430 N Wayne St, Suite 201, Angola, IN 46703 | 2007-11-09 |
| 1760537658 | Margaret Jean Schreiber | Nurse Practitioner | 103 Intertech Parkway, Suite A, Angola, IN 46703 | 2007-01-24 |
| 1922163120 | Tamara Lynn Watkins | Dentist | 101 N. Terrace Blvd., Angola, IN 46703 | 2006-12-27 |
| Find all providers in zip 46703 | ||||
| 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 |
|---|---|---|---|---|
| 1205286507 | Christina Basham | Skilled Nursing Facility | 710 Bluffview Dr, Angola, IN 46703-2206 | 2016-06-16 |
| 1265911630 | Aperion Care Angola LLC | Skilled Nursing Facility | 500 Williams St, Angola, IN 46703-1144 | 2018-08-07 |
| 1962490649 | Henry County Memorial Hospital | Skilled Nursing Facility | 500 Williams St, Angola, IN 46703-1144 | 2005-10-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023618956 | Empowerme Rehabilitation Illinois, LLC | Skilled Nursing Facility | 3203 E Moores Pike, Bloomington, IN 47401-7122 | 2020-10-29 |
| 1629698808 | Decatur County Memorial Hospital | Skilled Nursing Facility | 6712 Restoracy Drive, Whitestown, IN 46075-0089 | 2020-04-17 |
| 1922586510 | Aperion Care Marion LLC | Skilled Nursing Facility | 614 W 14th St, Marion, IN 46953-2158 | 2018-08-06 |
| 1427548270 | Vibra Rehabilitation Hospital of Southern Indiana, LLC | Skilled Nursing Facility | 3104 Blackiston Boulevard, New Albany, IN 47150-9579 | 2018-05-17 |
| 1952812034 | Blue Diamond Villas | Skilled Nursing Facility | 1510 Sandpiper Lane, Goshen, IN 46526 | 2017-10-17 |
| 1366974404 | Mika Riddle | Skilled Nursing Facility | 407 W Walnut St, Van Buren, IN 46991 | 2017-03-29 |
| 1245787076 | Sara Steffe | Skilled Nursing Facility | 1015 Virginia St, Ferdinand, IN 47532-9285 | 2016-09-09 |
| 1770030504 | Valerie Burdette | Skilled Nursing Facility | 1872 E County Road 825 S, Oakland City, IN 47660-8911 | 2016-09-09 |
| 1164878583 | Good Samaritan Hospital | Skilled Nursing Facility | 811 E. Baseline Road, Evansville, IN 47725-9340 | 2016-05-05 |
| 1598119968 | Harrison County Hospital | Skilled Nursing Facility | 702 N Sawyer Rd, Kendallville, IN 46755-2532 | 2016-04-21 |
| Find all providers with the same taxonomy | ||||
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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.