NPIMap

Organization Active NPI

Deaconess Memorial Medical Center, Inc.

Doing business as Memorial Hospital & Health Care Center

  • General Acute Care Hospital
  • Jasper, IN
National Provider Identifier
1003895947
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
050051021 Issued in IN
Legal business name
DEACONESS MEMORIAL MEDICAL CENTER, INC.
Doing business as
Deaconess Memorial Medical Center Inc
Practice address
800 W 9TH St
Jasper, IN 47546-2514
Phone
(812) 996-2345
Fax
(812) 996-0214
NPI assigned
Jan 10, 2006
Last updated
Apr 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Keith Miller
Title
Cao
Phone
(812) 996-0507

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 050051021 IN Primary

Addresses

Primary practice location

800 W 9TH St
Jasper, IN 47546-2514

Mailing address

800 W 9TH St
Jasper, IN 47546-2514
Phone (812) 996-2345

Other identifiers 2

IdentifierTypeStateIssuer
ANTHEM BLUE CROSSOtherIN000000097730
100268610AMedicaidIN

Other names 2

  • Deaconess Memorial Medical Center Inc Doing business as
  • Memorial Hospital & Health Care Center Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050218000032 IN Part A Provider - Hospital 4587578042 Practice locations: Dale, IN; Huntingburg, IN; Jasper, IN; Loogootee, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003895947. Details of each certification follow.

Hospital certification: CCN 150115

Legal name
DEACONESS MEMORIAL MEDICAL CENTER INC
Doing business as
DEACONESS MEMORIAL MEDICAL CENTER INC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Apr 10, 2019
Beds
123 (93 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
800 W 9TH St
Jasper, IN 47546-2514
Main/Primary Hospital Location
Hospital subgroups
Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Memorial Hospital and Health Care CenterCCN 150115 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Memorial Hospital Healt27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Tonya S Heim Individual Corporate Director Jan 1, 2013
Kristi M Nord Individual Corporate Director Jan 1, 2024
Renee Cunningham Individual Corporate DirectorBoard Vice Secretary Jan 1, 2012
Sohail Qadir Individual Corporate Director Jul 1, 2015
Shannon Ebenkamp Individual W-2 Managing EmployeeDirector of Finance Oct 8, 2024
James a Huebner Individual Corporate Director Jan 1, 2014
Deaconess Health System Inc Organization, Evansville, IN Chain home office 5% Or Greater Direct Ownership Interest Feb 1, 2024 100%
Lynn C Lingafelter Individual Corporate Director Feb 1, 2024
Christian Blome Individual Corporate Director Feb 1, 2024
Shawn W McCoy Individual Corporate Director Feb 1, 2024
Keith Miller Individual Corporate OfficerCao & Indiana Region President Oct 8, 2024
W-2 Managing Employee Oct 8, 2024
James Porter Individual Corporate Director Feb 1, 2024
Donna Balka Individual Corporate Director May 1, 2021
Nicholas a Werne Individual Corporate Director Aug 5, 2022

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mission Behavioral Health HospitalHuntingburg, IN, CCN 154072 Hospital 5% Or Greater Direct Ownership Interest (50%) Apr 5, 2024
Dale Family MedicineDale, IN, CCN 153859 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 2, 2000

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 28

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 28

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 438

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 438

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775606400000",
    "number": "1003895947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W 9TH ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475462514",
            "telephone_number": "812-996-2345",
            "fax_number": "812-996-0214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W 9TH ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475462514",
            "telephone_number": "812-996-2345",
            "fax_number": "812-996-0214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEACONESS MEMORIAL MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-10",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "812-996-0507",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IN",
            "license": "050051021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "000000097730",
            "identifier": "ANTHEM BLUE CROSS",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100268610A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deaconess Memorial Medical Center Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Memorial Hospital & Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Memorial Hospital & Health Care Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Jasper, IN

Sources for this page

Verify at the official NPI Registry.