MERCY LONG TERM CARE INITIATIVES, INC. (NPI# 1992792303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992792303 |
| Entity Type | Organization |
| Organization Name | MERCY LONG TERM CARE INITIATIVES, INC. |
| Other Organization Name | PROVIDENCE RETIREMENT HOME |
| Practice Address |
4915 Charlestown Rd New Albany IN 47150-9426 |
| Practice Telephone | 8129455221 |
| Practice Fax Number | 8129452614 |
| Mailing Telephone | 8129455221 |
| Mailing Fax Number | 8129452614 |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. WILLIAM ROBERT LEE (CFO) |
| Authorized Official Telephone | 8129455221 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | IN | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Providence Retirement Home | Doing Business As Name - Organization |
| Street Address |
4915 CHARLESTOWN RD |
| City | NEW ALBANY |
| State | IN |
| Zip Code | 47150-9426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073073987 | Tanner Scanlon | Occupational Therapist | 4915 Charlestown Rd, New Albany, IN 47150-9426 | 2019-03-25 |
| 1457833113 | Bradley Kruer | Physical Therapist | 4915 Charlestown Rd, New Albany, IN 47150-9426 | 2018-08-29 |
| 1306322821 | Bradley Martin Kimbel | Speech-Language Pathologist | 4915 Charlestown Rd, New Albany, IN 47150-9426 | 2018-07-17 |
| 1699264721 | Natalie Brooke Smith | Physical Therapist | 4915 Charlestown Rd, New Albany, IN 47150-9426 | 2018-05-03 |
| 1609365873 | Deanna Wallace | Occupational Therapist | 4915 Charlestown Rd, New Albany, IN 47150-9426 | 2018-05-03 |
| 1013404888 | Kumiko Peoples | Occupational Therapy Assistant | 4915 Charlestown Rd, New Albany, IN 47150-9426 | 2018-04-17 |
| 1891152583 | Melissa Gettelfinger | Occupational Therapist | 4915 Charlestown Rd, New Albany, IN 47150-9426 | 2016-01-26 |
| 1124485214 | Rachel Loran | Occupational Therapist | 4915 Charlestown Rd, New Albany, IN 47150-9426 | 2016-01-21 |
| 1033576277 | Amy Marie Braun | Occupational Therapist | 4915 Charlestown Rd, New Albany, IN 47150-9426 | 2016-01-19 |
| 1841625662 | Daviess County Hospital | Nursing Facility/Intermediate Care Facility | 4915 Charlestown Rd, New Albany, IN 47150-9426 | 2013-09-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396385050 | Essential Pediatrics | Physical Therapist | 1614 Slate Run Road, New Albany, IN 47150 | 2020-01-10 |
| 1871075234 | Katie Lyn Vincent | Speech-Language Pathologist | 845 Park Place, New Albany, IN 47150 | 2018-09-02 |
| 1326528811 | Donna Casey Laduke | Respiratory Therapist, Registered | Baptist Health Floyd, 1850 State Street, New Albany, IN 47150 | 2018-08-15 |
| 1003307232 | Shelby Paige Buffin | Social Worker | 1612 Dewey St., Bld. 6 Apt. 2, New Albany, IN 47150 | 2018-05-23 |
| 1104315902 | Whitney Nicole Malloy | Physician Assistant | 2108 State Street, New Albany, IN 47150 | 2018-05-07 |
| 1942728472 | Cleanse Clinic Jeffersonville LLC | Psychiatry & Neurology | 2818 Grant Line Rd Ste 2, New Albany, IN 47150 | 2017-09-05 |
| 1881110765 | Kristy Marie Delaney | Social Worker | 1144 Creekview Circle, New Albany, IN 47150 | 2017-08-22 |
| 1891217030 | Sarah H. Wilson | Physician Assistant | 1919 State St Ste 362, New Albany, IN 47150 | 2017-07-10 |
| 1861939290 | Lauren Brenneman Pollock | Audiologist | 3211 Grant Line Rd St. #37, New Albany, IN 47150 | 2017-01-24 |
| 1861850414 | Kiley Madaleno | Speech-Language Pathologist | 4915 Charlestown Road, New Albany, IN 47150 | 2016-02-10 |
| Find all providers in zip 47150 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841625662 | Daviess County Hospital | Nursing Facility/Intermediate Care Facility | 4915 Charlestown Rd, New Albany, IN 47150-9426 | 2013-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871040659 | Stephanie Hentrup | Nursing Facility/Intermediate Care Facility | 621 E 20th St, Ferdinand, IN 47532-9220 | 2016-09-08 |
| 1912354630 | Denise Chambery | Nursing Facility/Intermediate Care Facility | 5707 W 122nd Pl, Crown Point, IN 46307-8778 | 2016-05-23 |
| 1124494760 | Maplemanor Christian Home, Inc. | Nursing Facility/Intermediate Care Facility | 643 W Utica St, Sellersburg, IN 47172-1163 | 2015-08-18 |
| 1174868822 | Daviess County Hospital | Nursing Facility/Intermediate Care Facility | 120 East Miller Drive, Bloomington, IN 47407-6538 | 2012-12-06 |
| 1134493281 | Adams County Memorial Hospital | Nursing Facility/Intermediate Care Facility | 9802 Coldwater Road, Fort Wayne, IN 46825 | 2012-03-06 |
| 1447481049 | Larry Wayne Sims | Nursing Facility/Intermediate Care Facility | 1236 Lincoln Ave, Evansville, IN 47714-1056 | 2009-07-30 |
| 1720253313 | Davis Elderly Care, LLC | Nursing Facility/Intermediate Care Facility | 5139 S Hanover Saluda Rd, Hanover, IN 47243-9212 | 2008-04-24 |
| 1750585766 | Gosport Care, Inc. | Nursing Facility/Intermediate Care Facility | 27 S. 7th St., Gosport, IN 47433-0099 | 2007-06-13 |
| 1790986792 | Evansville Protestant Home Inc. | Nursing Facility/Intermediate Care Facility | 3701 Washington Ave, Evansville, IN 47714-0544 | 2007-05-29 |
| 1881816148 | Pulaski Memorial Hospital | Nursing Facility/Intermediate Care Facility | 505 North Gavin Street, Muncie, IN 47303 | 2007-05-03 |
| Find all providers with the same taxonomy | ||||
| City | NEW ALBANY |
| Zip Code | 47150 |
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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.