PULASKI MEMORIAL HOSPITAL (NPI# 1932196177) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932196177 |
| Entity Type | Organization |
| Organization Name | PULASKI MEMORIAL HOSPITAL |
| Other Organization Name | KINGSTON CARE CENTER OF FORT WAYNE |
| Practice Address |
1010 W Washington Center Rd Ft Wayne IN 46825-4155 |
| Mailing Address |
616 E 13th St Winamac IN 46996-1117 |
| Practice Telephone | 2604892552 |
| Practice Fax Number | 2604879912 |
| Mailing Telephone | 4192472880 |
| Mailing Fax Number | 4192472872 |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2016-02-01 |
| Authorized Official Name | MR. GREGG MALOTT (DIRECTOR OF BUSINESS DEVELOPMENT) |
| Authorized Official Telephone | 57494624100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 05-000522-1 | IN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM | 000000204329 | 01 |
| IN | 100267040A | 05 |
| Other Name | Type Code |
|---|---|
| Kingston Care Center of Fort Wayne | 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 |
| 1306837869 | Pulaski Memorial Hospital | Skilled Nursing Facility | 516 Williams St, Angola, IN 46703-1144 | 2005-11-03 |
| 1811987894 | Pulaski Memorial Hospital | Skilled Nursing Facility | 643 West Utica Street, Sellersburg, IN 47172-1163 | 2005-10-21 |
| 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 |
1010 W WASHINGTON CENTER RD |
| City | FT WAYNE |
| State | IN |
| Zip Code | 46825-4155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772078 | Bradley Murphy | Occupational Therapist | 2626 St Joe Center Ed, Fort Wayne, IN 46825 | 2020-02-21 |
| 1144851015 | Sabryna Roman | Developmental Therapist | 2626 St Joe Center Rd, Fort Wayne, IN 46825 | 2020-01-30 |
| 1205474103 | Ashleigh Miller | Developmental Therapist | 2626 St. Joe Center Rd, Fort Wayne, IN 46825 | 2019-12-11 |
| 1962055152 | Carehalo Ohio LLC | General Practice | 2510 Dupont Circle Dr., Suite 201, Fort Wayne, IN 46825 | 2019-07-17 |
| 1306318175 | Logan Alan Williams | Nurse Anesthetist, Certified Registered | 10315 Dawsons Creek Blvd Ste B, Fort Wayne, IN 46825 | 2018-12-18 |
| 1326582925 | Mark F Stoner LLC | Dentist | 9830 Auburn Rd Suite 102, Fort Wayne, IN 46825 | 2016-12-15 |
| 1336695782 | Nadine Rene' Handy | Nurse Practitioner | 3978 New Vision Dr., Fort Wayne, IN 46825 | 2016-08-26 |
| 1558815712 | Nathan Paul Miller | Physical Therapist | 10006 Auburn Park Dr, Fort Wayne, IN 46825 | 2016-08-05 |
| 1013366905 | Brianna Abbott | Physician Assistant | 1234 E Dupont Rd Ste 7, Fort Wayne, IN 46825 | 2016-06-10 |
| 1003276643 | Seiss, LLC | Psychologist | 9910 Dupont Circle Drive, Suite 140, Fort Wayne, IN 46825 | 2016-02-24 |
| Find all providers in zip 46825 | ||||
| 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 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PULASKI 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.