NPIMap

Organization Active NPI

Union Hospital Inc

Doing business as Brazil Family Medicine

  • Rural Health Clinic/Center
  • Brazil, IN
National Provider Identifier
1013087048
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
UNION HOSPITAL INC
Doing business as
Brazil Family Medicine
Practice address
115 S Murphy Ave
Ste a
Brazil, IN 47834-8296
Phone
(812) 442-2100
NPI assigned
Nov 8, 2006
Last updated
Jul 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Authorized official

Name
Steve Holman
Title
Ceo
Phone
(812) 238-7606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X IN Primary

Addresses

Primary practice location

115 S Murphy Ave
Ste a
Brazil, IN 47834-8296

Mailing address

221 S 6TH St
Terre Haute, IN 47807-4214
Phone (812) 242-3157

Other names 1

  • Brazil Family Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040519000807 IN Part B Supplier - Clinic/Group Practice 8426943614 Receives reassigned benefits from 126 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Terre Haute, IN; W Terre Haute, IN; Brazil, IN; Clay City, IN; Clinton, IN; Greencastle, IN; Riley, IN; Rockville, IN…
O20170223001026 IN Part A Provider - Rural Health Clinic 8426943614 Practice locations: Brazil, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013087048. Details of each certification follow.

Rural health clinic certification: CCN 153869

Legal name
UNION HOSPITAL INC
Doing business as
BRAZIL FAMILY MEDICINE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 7, 2003
Last certification
Aug 11, 2021
Ownership / control type
2B
Most recent change of ownership
Sep 30, 2016 (2 total)
Organization structure
CorporationNon-profit
Incorporated
May 6, 1895 in IN
Enrollment address
115 S Murphy Ave
Ste a
Brazil, IN 47834-8296

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0933462Brazil Family Medicine115 S Murphy Ave, Ste a, Brazil, IN 47834Provider-performed microscopySep 11, 2027

National Provider Directory

National Provider Directory
Tax ID family
Bala C Rangaswami MD30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

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

View all 29

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

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
John Aidoo Individual Corporate DirectorBoard Member Jan 1, 2021
Mary Doti Individual Corporate DirectorBoard Member Jan 1, 2018
Tim Sullivan Individual Corporate OfficerAssistant Treasurer Jan 1, 2021
Corporate DirectorBoard Member Jan 1, 2021
Robert a Coons Individual Corporate OfficerVice Chair Oct 1, 2016
Corporate DirectorBoard Member Oct 23, 2014
John C Etling Individual Corporate DirectorBoard Member Jan 1, 2019
Kenneth M Kigorwe Individual OtherBoard Member Jan 1, 2023
Luke Terry Individual Corporate OfficerTreasurer Jan 1, 2021
Corporate DirectorBoard Member Jan 1, 2021
Kathleen D Coutinho Individual Corporate DirectorBoard Member Jan 1, 2019
Donald T Scott Individual Corporate DirectorBoard Member Oct 23, 2014
Steven M Holman Individual Corporate DirectorPresident & Ceo of Union Hospital, Apr 30, 2014
W-2 Managing EmployeePresident and Ceo of Union Hospital Apr 30, 2014
Richard Templeton Individual OtherBoard Member Jan 1, 2024
Sara D Smith Individual Corporate OfficerSecretary Oct 1, 2016
Corporate DirectorBoard Member Oct 23, 2014
Molly a Callahan Individual Corporate DirectorBoard Member Oct 1, 2005
Union Hospital Inc Organization, Brazil, IN Non-profit 5% Or Greater Direct Ownership Interest Sep 30, 2016 100%

Owners & managing parties with NPI records 10

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

All facility ownership & control disclosures 7

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

FacilityTypeRoleSince
Union Hospital ClintonClinton, IN, CCN 151326 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 27, 2005
Union Hospital IncTerre Haute, IN, CCN 150023 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Union Hospital Medical Rehabilitation UnitTerre Haute, IN, CCN 15T023 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 1, 1989
Union Hospital ClintonClinton, IN, CCN 15Z326 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 27, 2005
Union Hospital IncTerre Haute, IN, CCN 15S023 Hospital 5% Or Greater Indirect Ownership Interest Jan 1, 1966
Cork Medical CenterMarshall, IL, CCN 148987 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2001
Clay City Center for Family MedicineClay City, IN, CCN 153804 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Dec 10, 1993

Owned or controlled facilities with NPI records 9

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

Facilities with the same owner 7

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

Change-of-ownership history 2

DateEventCounterparty
Sep 30, 2016 Change of OwnershipThis provider was the buyer Brazil Family MedicineCCN 153869, IN, NPI 1013087048
Sep 30, 2016 Change of OwnershipThis provider was the seller Brazil Family MedicineCCN 153869, IN, NPI 1013087048

Practitioners & affiliated clinicians

Practitioners 26

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.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689811200000",
    "number": "1013087048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 S 6TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478074214",
            "telephone_number": "812-242-3157",
            "fax_number": "812-242-3861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S MURPHY AVE",
            "address_2": "STE A",
            "city": "BRAZIL",
            "state": "IN",
            "postal_code": "478348296",
            "telephone_number": "812-442-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNION HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A",
        "authorized_official_last_name": "HOLMAN",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-238-7606"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brazil Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brazil Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brazil, IN

Sources for this page

Verify at the official NPI Registry.