ADAMS COUNTY MEMORIAL HOSPITAL (NPI# 1477699460) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477699460 |
| Entity Type | Organization |
| Organization Name | ADAMS COUNTY MEMORIAL HOSPITAL |
| Other Organization Name | OAK VILLAGE |
| Practice Address |
200 West Fourth Dtreet Oaktown IN 47561-8081 |
| Mailing Address |
1100 Mercer Avenue Decatur IN 46733 |
| Practice Telephone | 8127452360 |
| Mailing Telephone | 2607242145 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2018-05-15 |
| Authorized Official Name | MR. DANE E. WHEELER (CFO) |
| Authorized Official Telephone | 2607242145 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 314000000X | Skilled Nursing Facility | 06-000517-1 | IN | Nursing & Custodial Care Facilities |
| Y | 314000000X | Skilled Nursing Facility | 13-000517-1 | IN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | BLUE CROSS BLUE SHIELD | 000000304243 | 01 |
| IN | 100266770 A | 05 |
| Other Name | Type Code |
|---|---|
| Oak Village | 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 |
| 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 |
| 1609977628 | Adams County Memorial Hospital | Skilled Nursing Facility | 2400 College Avenue, Goshen, IN 46528 | 2006-09-25 |
| 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 |
200 WEST FOURTH DTREET |
| City | OAKTOWN |
| State | IN |
| Zip Code | 47561-8081 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568643948 | L Renee Goodwin Dds Inc | Dentist | 100 N. Broadway Street, Oaktown, IN 47561-0269 | 2007-11-14 |
| 1124199393 | Stephen J Holka | Dentist | 100 N. Broadway Street, Oaktown, IN 47561-0269 | 2006-11-10 |
| 1518905389 | Leah Renee Goodwin | Dentist | 100 N. Broadway Street, Oaktown, IN 47561-7000 | 2006-06-03 |
| 1619416542 | Jayme Lane | Physical Therapy Assistant | 200 W 4th St, Oaktown, IN 47561-8081 | 2017-02-12 |
| 1255743076 | Holly Laue | Nurse Practitioner | 6331 E Freelandville Rd, Oaktown, IN 47561-8203 | 2014-05-28 |
| 1811478530 | Josie Eaton | Speech-Language Pathologist | 15261 N Mouzin Rd, Oaktown, IN 47561-8301 | 2018-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811478530 | Josie Eaton | Speech-Language Pathologist | 15261 N Mouzin Rd, Oaktown, IN 47561-8301 | 2018-08-22 |
| 1255743076 | Holly Laue | Nurse Practitioner | 6331 E Freelandville Rd, Oaktown, IN 47561-8203 | 2014-05-28 |
| 1518905389 | Leah Renee Goodwin | Dentist | 100 N. Broadway Street, Oaktown, IN 47561-7000 | 2006-06-03 |
| 1568643948 | L Renee Goodwin Dds Inc | Dentist | 100 N. Broadway Street, Oaktown, IN 47561-0269 | 2007-11-14 |
| 1124199393 | Stephen J Holka | Dentist | 100 N. Broadway Street, Oaktown, IN 47561-0269 | 2006-11-10 |
| 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 |
|---|---|---|---|---|
| 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 |
| 1205286507 | Christina Basham | Skilled Nursing Facility | 710 Bluffview Dr, Angola, IN 46703-2206 | 2016-06-16 |
| 1164878583 | Good Samaritan Hospital | Skilled Nursing Facility | 811 E. Baseline Road, Evansville, IN 47725-9340 | 2016-05-05 |
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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.