NPIMap

Organization Active NPI

Memorial Home Care, Inc.

Doing business as Family Nursing Services

  • Home Health Agency
  • Elkhart, IN
National Provider Identifier
1053660811
Registry record updated Mar 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
12-005298-1 Issued in IN
Legal business name
MEMORIAL HOME CARE, INC.
Doing business as
Family Nursing Services
Practice address
58025 County Road 9
Elkhart, IN 46517-2260
Phone
(574) 266-3661
NPI assigned
Sep 7, 2012
Last updated
Mar 8, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2013

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

Authorized official

Name
Greg Conrad, MBA
Title
Vice President
Phone
(574) 647-8777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 12-005298-1 IN Primary

Addresses

Primary practice location

58025 County Road 9
Elkhart, IN 46517-2260

Mailing address

3355 Douglas Rd
South Bend, IN 46635-1781
Phone (574) 273-2273

Other identifiers 2

IdentifierTypeStateIssuer
100091080BMedicaidIN
100263690COtherINWAIVER

Other names 1

  • Family Nursing Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Beacon Health Ventures Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1346976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362700800000",
    "number": "1053660811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 DOUGLAS RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351781",
            "telephone_number": "574-273-2273",
            "fax_number": "574-273-5605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58025 COUNTY ROAD 9",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465172260",
            "telephone_number": "574-266-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HOME CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-07",
        "last_updated": "2013-03-08",
        "status": "A",
        "authorized_official_last_name": "CONRAD",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "574-647-8777",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IN",
            "license": "12-005298-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100091080B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WAIVER",
            "identifier": "100263690C",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Nursing Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.