ADAMS COUNTY MEMORIAL HOSPITAL (NPI# 1821185356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821185356 |
| Entity Type | Organization |
| Organization Name | ADAMS COUNTY MEMORIAL HOSPITAL |
| Other Organization Name | SANCTUARY AT HOLY CROSS |
| Practice Address |
17475 Dugdale Dr South Bend IN 46635-1545 |
| Mailing Address |
1100 Mercer Ave Decatur IN 46733-2303 |
| Practice Telephone | 2192713990 |
| Practice Fax Number | 2192713981 |
| Mailing Telephone | 2607242145 |
| Mailing Fax Number | 2607283867 |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2018-02-07 |
| Authorized Official Name | MR. DANE WHEELER (CFO) |
| Authorized Official Telephone | 2607242145 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 17-001201-1 | IN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100380860 | 05 |
| Other Name | Type Code |
|---|---|
| Sanctuary at Holy Cross | 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 |
| 1477699460 | Adams County Memorial Hospital | Skilled Nursing Facility | 200 West Fourth Dtreet, Oaktown, IN 47561-8081 | 2007-01-29 |
| 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 |
| 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 |
17475 DUGDALE DR |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46635-1545 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528437 | Montana M Hunter | Occupational Therapy Assistant | 17475 Dugdale Dr, South Bend, IN 46635-1545 | 2020-11-03 |
| 1750911350 | Rodney Alan Perry Jr. | Physical Therapy Assistant | 17475 Dugdale Dr, South Bend, IN 46635-1545 | 2020-01-22 |
| 1427698307 | Boaz Nyongesa Barasa | Physical Therapy Assistant | 17475 Dugdale Dr, South Bend, IN 46635-1545 | 2020-01-08 |
| 1790347318 | Victoria Wozniski | Physical Therapist | 17475 Dugdale Dr, South Bend, IN 46635-1545 | 2019-07-03 |
| 1669935300 | Elias Gathenya | Occupational Therapy Assistant | 17475 Dugdale Dr, South Bend, IN 46635-1545 | 2019-04-10 |
| 1689758575 | Trinity Continuing Care Services | Durable Medical Equipment & Medical Supplies | 17475 Dugdale Dr, South Bend, IN 46635-1545 | 2006-10-25 |
| 1326122300 | Trinity Continuing Care Services | Skilled Nursing Facility | 17475 Dugdale Dr, South Bend, IN 46635-1545 | 2006-10-25 |
| 1407930498 | Trinity Continuing Care Services | Durable Medical Equipment & Medical Supplies | 17475 Dugdale Dr, South Bend, IN 46635-1545 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295078228 | Michael Pfeiffer | Otolaryngology | 6301 University Commons Ste 360, South Bend, IN 46635 | 2013-03-27 |
| 1679833438 | Whitney Moore | Physical Therapy Assistant | 2012 Ironwood Circle, Suite 230, Circle Centre Building, South Bend, IN 46635 | 2012-05-25 |
| 1992917637 | Elly May Wynia | Social Worker | 53700 Generations Drive, Suite 200, South Bend, IN 46635 | 2007-05-04 |
| 1891917282 | Lifetime Dental Careof Indiana, PC | Dentist | 1605 North Ironwood, South Bend, IN 46635 | 2007-05-03 |
| 1750502878 | Tyrone Arteese Armstead | Pharmacist | 3355 Douglas Rd, South Bend, IN 46635 | 2007-05-02 |
| 1013033794 | Bradley Richard Swanson | Dentist | 54505 26th Street, Unit E, South Bend, IN 46635 | 2007-03-22 |
| 1225185739 | Michael J. O'connell D.o. Inc | Family Medicine | 17960 Cleveland Road, South Bend, IN 46635 | 2007-01-05 |
| 1346300365 | Chad Fulton Harrington | Dentist | 3340 Douglas Rd., South Bend, IN 46635 | 2006-12-11 |
| 1346313236 | Dr Shawn R Long Dds PC | Dentist | 16329 State Rd 23, South Bend, IN 46635 | 2006-11-16 |
| 1134206576 | Kearn David Hinchman | Psychiatry & Neurology | 53779 Generations Drive, Suite 1, South Bend, IN 46635 | 2006-11-01 |
| Find all providers in zip 46635 | ||||
| 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 |
|---|---|---|---|---|
| 1821427857 | Hancock Regional Hospital | Skilled Nursing Facility | 52565 Sr 933, South Bend, IN 46637 | 2013-11-12 |
| 1295064525 | Starlight Care Facilities, Inc | Skilled Nursing Facility | 915 So. 27th Street, South Bend, IN 46615 | 2009-12-16 |
| 1669544516 | Indiana Health and Rehabilitation Centers | Skilled Nursing Facility | 1950 Ridgedale Rd, South Bend, IN 46614-2243 | 2006-11-15 |
| 1871674556 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 4600 W Washington St, South Bend, IN 46619 | 2006-10-18 |
| 1235219148 | Janeczko Properties LLC | Skilled Nursing Facility | 206 E Marion St, South Bend, IN 46601-1029 | 2006-10-16 |
| 1093750119 | St. Clair Darden Health System Inc | Skilled Nursing Facility | 20531 Darden Rd, South Bend, IN 46637-2915 | 2006-06-20 |
| 1841287232 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 1121 E Lasalle Ave, South Bend, IN 46617 | 2005-09-30 |
| 1477913754 | Chalet of Hastings LLC | Skilled Nursing Facility | 6101 Nimtz Pkwy, South Bend, IN 46628-6111 | 2016-03-01 |
| 1487044822 | Decatur County Memorial Hospital | Skilled Nursing Facility | 5024 W Western Ave, South Bend, IN 46619-2312 | 2015-01-23 |
| 1194167650 | Pulaski Memorial Hospital | Skilled Nursing Facility | 206 E Marion St, South Bend, IN 46601-1029 | 2013-07-25 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46635 |
Please comment or provide details below to improve the information on ADAMS COUNTY MEMORIAL HOSPITAL.
| 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.