St. Vincent Hospital and Health Care Center, Inc.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

Legal business name

ST. VINCENT HOSPITAL AND HEALTH CARE CENTER, INC.

Practice address

2200 Randallia Dr
Fort Wayne, IN 46805-4638

Phone

(800) 727-8439

NPI assigned

Sep 11, 2007

Organization subpart

Yes

Parent organization

ST. VINCENT HOSPITAL AND HEALTH CARE CENTER, INC.As reported in NPPES

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

Authorized official

Name

D. Bruce Haga

Title

Vice President

Phone

(317) 583-3087

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• ST. VINCENT PEDIATRIC SUBSPECIALTIES Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• St Vincent Physician Services Hospital and Health Care Center

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1669422234

  O20040223001092

  Same enrollment

Tax ID family

St Vincent Hospital and Health Care Center Inc4 organizations share this tax ID, including this one

Part of

Fred Sanders MD PC

Other organizations with this tax ID 3

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

• St Vincent Pediatric Subspecialties

  • Pediatric Critical Care Medicine Physician
  • Evansville, IN
  • NPI 1851950224
  NPD tax ID
• St. Vincent Children'S Hospital

  • Clinic/Center
  • Zionsville, IN
  • NPI 1669442802
  NPD tax ID
• St. Vincent Hospital and Health Care Center, Inc.

  • Pediatric Gastroenterology Physician
  • Indianapolis, IN
  • NPI 1316205495
  NPD tax ID

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1023203239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10330 N MERIDIAN ST",
            "address_2": "SUITE 201",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462901024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 RANDALLIA DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054638",
            "telephone_number": "800-727-8439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VINCENT HOSPITAL AND HEALTH CARE CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. VINCENT HOSPITAL AND HEALTH CARE CENTER, INC.",
        "enumeration_date": "2007-09-11",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "HAGA",
        "authorized_official_first_name": "D.",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "317-583-3087"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0216X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200505130W",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST. VINCENT PEDIATRIC SUBSPECIALTIES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• St Joseph Medical Group Inc
• St. Joseph Health System LLC
• St. Joseph Health System, LLC
• St. Joseph Health System, LLC
• St. Joseph Township EMS
• Jeff S Stachera, LMHC, MS ED
• Brent A Stachler, LMFT, MAC, MS ED
• Julie R. Stackhouse, CNM
• Kara N Stackhouse
• Dana L Staddon, FNP-C

• All providers in Fort Wayne, IN
• Neonatal-Perinatal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.