Indiana University Health Ball Memorial Hospital, Inc.
Organization Active NPI Pediatric Rehabilitation Medicine Physician · Muncie, IN
NPI 1073164646 · NPPES record last updated Sep 25, 2019
Key facts
- NPI
- 1073164646
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatric Rehabilitation Medicine Physician 2081P0010X
- Legal business name
- INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL, INC.
- Practice address
- 4870 E Jackson St
Muncie, IN 47303-4432 - Phone
- (765) 254-9717
- Fax
- (765) 254-9739
- NPI assigned
- Sep 25, 2019
- Organization subpart
- No
Authorized official
- Name
- Mr. Jonathan Vanator
- Title
- Cfo
- Phone
- (765) 741-2891
Other NPIs with the same Medicare PAC ID 6
Corporate family (same tax ID) 11
Practitioners 5
-
Megan Leigh Smith, CCC-SLP
-
Christina M Douglas, OTD, MOT, OTR
-
Mary A McCaslin, OT
-
Kaitlin Lynn Sanders, PT, DPT
-
Alesia Struewing, SLP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191121003172 | IN | Part B Supplier - Clinic/Group Practice | 5698688273 |
Receives reassigned benefits from 1 practitioner Practice locations: Muncie, IN |
National Provider Directory
- Tax ID family
- Indiana University HLTH Inc
Locations
3793 Solutions Ctr
Chicago, IL 60677
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Rehabilitation Medicine Physician |
2081P0010X | Yes | ||
| Physical Therapist |
225100000X | |||
| Pediatric Physical Therapist |
2251P0200X | |||
| Occupational Therapist |
225X00000X | |||
| Pediatric Occupational Therapist |
225XP0200X | |||
| Speech-Language Pathologist |
235Z00000X |
Addresses
Primary practice location
4870 E Jackson St
Muncie, IN 47303-4432
Mailing address
1200 W White River Blvd
Attn: Provider Enrollment
Muncie, IN 47303-4988
Phone (765) 282-8991
Other providers in Muncie, IN
- Indiana University Health Ball Memorial Hospital
- Indiana University Health Ball Memorial Hospital Inc
- Indiana University Health Ball Memorial Hospital Inc
- Indiana University Health Ball Memorial Hospital Inc
- Indiana University Health Ball Memorial Hospital Inc
- Indiana University Health Ball Memorial Hospital, Inc.
- Indiana University Health Ball Memorial Hospital, Inc.
- Indiana University Health Ball Memorial Hospital, Inc.
- Indiana University Health Ball Memorial Hospital, Inc.
- Indiana University Health Ball Memorial Medical Group, LLC
All providers in Muncie, IN · Pediatric Rehabilitation Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.