ST. MARY MEDICAL CENTER (NPI# 1952458564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952458564 |
| Entity Type | Organization |
| Organization Name | ST. MARY MEDICAL CENTER |
| Other Organization Name | ST. MARY MEDICAL CENTER CRNA |
| Practice Address |
1500 S Lake Park Ave Hobart IN 46342-6638 |
| Practice Telephone | 2199476980 |
| Practice Fax Number | 2199476037 |
| Mailing Telephone | 2199476980 |
| Mailing Fax Number | 2199476037 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MARY SUDICKY (CFO) |
| Authorized Official Telephone | 2199476014 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| St. Mary Medical Center CRNA | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669456299 | St. Mary Medical Center | General Acute Care Hospital | 18300 Highway 18, Apple Valley, CA 92307 | 2005-12-06 |
| 1285007419 | St. Mary Medical Center | Clinic/Center | 1045 Atlantic Ave, Suite 914, Long Beach, CA 90813-3408 | 2015-11-10 |
| 1740698497 | St. Mary Medical Center | General Acute Care Hospital | 1707 N Henderson St, Galesburg, IL 61401-1320 | 2014-07-25 |
| 1487078796 | St. Mary Medical Center | Ambulance | 1201 Langhorne Newtown Rd, Langhorne, PA 19047-1201 | 2014-02-06 |
| 1043406440 | St. Mary Medical Center | Advanced Practice Midwife | 18077 Us Highway 18, Apple Valley, CA 92307-2150 | 2007-09-19 |
| 1982899266 | St. Mary Medical Center | General Acute Care Hospital | 401 W Poplar St, Walla Walla, WA 99362-2846 | 2007-09-11 |
| 1700921541 | St. Mary Medical Center | Internal Medicine | 2241 45th St, Highland, IN 46322-2601 | 2007-02-20 |
| 1457425605 | St. Mary Medical Center | Internal Medicine | 300 W 80th Pl, Ste A, Merrillville, IN 46410-5456 | 2006-11-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ST. MARY MEDICAL CENTER | 1201 Langhorne - Newtown Rd, Langhorne, PA 19047-1201 |
| Washington State Corporations | ST. MARY MEDICAL CENTER | 401 W Poplar St, Walla Walla, WA 99362 |
| Indiana Business Entities | ST. MARY MEDICAL CENTER DEVELOPMENT, LLC | St. Mary Medical Center, 1500 S. Lake Park Ave., Hobart, IN 46342 |
| System for Award Management (SAM) Entities | ST. MARY MEDICAL CENTER FOUNDATION | 1050 Linden Ave, Long Beach, CA 90813-3321 |
| System for Award Management (SAM) Entities | ST. MARY MEDICAL CENTER, INC. | 1500 S Lake Park Ave, Hobart, IN 46342-6638 |
| Street Address |
1500 S LAKE PARK AVE |
| City | HOBART |
| State | IN |
| Zip Code | 46342-6638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346233574 | Aram Semerdjian | Radiology | 1500 S Lake Park Ave, Munster Radiology Group, Hobart, IN 46342-6638 | 2005-08-23 |
| 1275130841 | Giovanna Finigan | Occupational Therapy Assistant | 1500 S Lake Park Ave, Hobart, IN 46342-6699 | 2020-10-06 |
| 1699329185 | Allyson Trevino | Pharmacist | 1500 S Lake Park Ave, Hobart, IN 46342-6638 | 2019-08-01 |
| 1306401914 | Chasity Lynn Stahl | Nurse Anesthetist, Certified Registered | 1500 S Lake Park Ave, Hobart, IN 46342-6638 | 2019-05-08 |
| 1013497106 | 24 On Physician Partners, PC | Hospitalist | 1500 S Lake Park Ave, Hobart, IN 46342-6638 | 2018-08-17 |
| 1255819405 | Nichole Marie Patten | Nurse Practitioner | 1500 S Lake Park Ave, Hobart, IN 46342-6638 | 2018-07-31 |
| 1417445842 | Tia Sparks | Pharmacist | 1500 S Lake Park Ave, Hobart, IN 46342-6638 | 2018-05-01 |
| 1043708464 | Joyce C Smith | Pharmacist | 1500 S Lake Park Ave, Hobart, IN 46342-6638 | 2018-05-01 |
| 1962900696 | Laura Bertucci | Pharmacist | 1500 S Lake Park Ave, Hobart, IN 46342-6638 | 2018-01-29 |
| 1235637844 | Deborah Ann Evans | Pharmacist | 1500 S Lake Park Ave, Hobart, IN 46342-6638 | 2018-01-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952734295 | Carleen Kaucky | Nurse Practitioner | 1445 South Lake Park Ave, Hobart, IN 46342 | 2013-08-09 |
| 1679827133 | Fresenius Medical Care Nw Indiana, LLC | Clinic/Center | 1330 W. Wisconsin St., Hobart, IN 46342 | 2012-11-06 |
| 1356600548 | Accurate Home Health Inc | Home Health | 8792 E. Ridge Road, Suite A, Hobart, IN 46342 | 2012-05-09 |
| 1164728051 | Lynn Rentz | Mechanotherapist | 103 E.third St., Suite 1, Hobart, IN 46342 | 2011-02-10 |
| 1720214208 | Felipe Isip Chua Jr. | Physician Assistant | 101 West 61st Avenue, Hobart, IN 46342 | 2009-06-10 |
| 1326289067 | Sheila Anne Flynn | Registered Nurse | 101 W. 61st Ave., Hobart, IN 46342 | 2009-03-10 |
| 1194941021 | Arc Bridges, Inc | Custodial Care Facility | 3583 Randolph Drive, Hobart, IN 46342 | 2007-04-18 |
| 1164542940 | Felix Rosel Gozo Jr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1354 S Lake Park Avenue, St Marys Spectrum Rehab Center Cardiac, Hobart, IN 46342 | 2007-03-29 |
| 1003932666 | Major Hospital | Skilled Nursing Facility | 4410 W 49th Ave, Hobart, IN 46342 | 2007-03-22 |
| 1295884682 | Marie Jean Mercado Hedges | Physical Therapist | 4530 16th St., Hobart, IN 46342 | 2007-01-09 |
| Find all providers in zip 46342 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578663977 | Sandy Jay Penner | Nurse Anesthetist, Certified Registered | 429 West Elm Street., Hobart, OK 73651 | 2006-09-25 |
| 1306401914 | Chasity Lynn Stahl | Nurse Anesthetist, Certified Registered | 1500 S Lake Park Ave, Hobart, IN 46342-6638 | 2019-05-08 |
| 1659567154 | Benedict Charlley | Nurse Anesthetist, Certified Registered | 1500 S Lake Park Ave, Hobart, IN 46342-6638 | 2007-09-18 |
| 1114113610 | Steven Burkett | Nurse Anesthetist, Certified Registered | 1500 S Lake Park Ave, Hobart, IN 46342-6638 | 2007-09-18 |
| 1700837085 | Stephanie Dines | Nurse Anesthetist, Certified Registered | 1500 S Lake Park Ave, Hobart, IN 46342-6638 | 2006-05-12 |
| 1619928058 | Kenneth A Ebert | Nurse Anesthetist, Certified Registered | 1500 S Lake Park Ave, Hobart, IN 46342-6638 | 2006-05-12 |
| 1174574487 | Rodrigo Garcia | Nurse Anesthetist, Certified Registered | 1500 S Lake Park Ave, Hobart, IN 46342-6638 | 2006-05-12 |
| 1023069366 | Charles C Kalbfell | Nurse Anesthetist, Certified Registered | 1500 S Lake Park Ave, Hobart, IN 46342-6638 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467067579 | Apollo Medical Group of Lake George LLC | Nurse Anesthetist, Certified Registered | 6245 N Old 27, Fremont, IN 46737-8711 | 2020-09-15 |
| 1053938324 | Sara Rosemarie Saylor | Nurse Anesthetist, Certified Registered | 4455 Edison Lakes Pkwy # 100, Mishawaka, IN 46545-1414 | 2020-07-02 |
| 1831738657 | William K Mitchell V | Nurse Anesthetist, Certified Registered | 85 E Us-6 Frontage Rd, Valparaiso, IN 46385 | 2019-12-26 |
| 1891333522 | Adam Collier | Nurse Anesthetist, Certified Registered | 600 Elkhart Boulvard, Elkhart, IN 46514 | 2019-12-12 |
| 1912540931 | Evin Anesthesia, LLC | Nurse Anesthetist, Certified Registered | 1101 Professional Blvd Ste 104, Evansville, IN 47714-8018 | 2019-10-22 |
| 1427619840 | Ams Northern Indiana LLC | Nurse Anesthetist, Certified Registered | 3212 Hickory Rd Ste A, Mishawaka, IN 46545-8863 | 2019-06-26 |
| 1013475375 | Vigilance Anesthesiologists & Pain Specialists PC | Nurse Anesthetist, Certified Registered | 5363 Commerce Blvd, Crown Point, IN 46307-5325 | 2019-03-06 |
| 1023572781 | Allied Anesthesia Associates, LLC | Nurse Anesthetist, Certified Registered | 53990 Carmichael Dr Ste 100, South Bend, IN 46635-1585 | 2019-01-28 |
| 1306318175 | Logan Alan Williams | Nurse Anesthetist, Certified Registered | 10315 Dawsons Creek Blvd Ste B, Fort Wayne, IN 46825 | 2018-12-18 |
| 1275018236 | Indiana Ams LLC | Nurse Anesthetist, Certified Registered | 9200 Calumet Ave Ste 200, Munster, IN 46321-2885 | 2018-09-26 |
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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.