NPIMap

Organization Active NPI

Harrison County Hospital

Doing business as Harrison County EMS

  • Ambulance
  • Corydon, IN
National Provider Identifier
1073620001
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
0325 Issued in IN
Legal business name
HARRISON COUNTY HOSPITAL
Doing business as
Harrison County EMS
Practice address
1141 Hospital Dr NW
Corydon, IN 47112-2164
Phone
(812) 738-4251
Fax
(812) 738-7833
NPI assigned
Aug 24, 2006
Last updated
Nov 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Authorized official

Name
Donald Duval
Title
Cfo
Phone
(812) 734-3861

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 05005073-1 IN
Ambulance 341600000X 06-004773-1 IN
Ambulance 341600000X 0325 IN Primary

Addresses

Primary practice location

1141 Hospital Dr NW
Corydon, IN 47112-2164

Mailing address

PO Box 38
Corydon, IN 47112-0038
Phone (812) 738-4251

Other identifiers 5

IdentifierTypeStateIssuer
01340306MedicaidKY
100128260AMedicaidIN
1065774MedicaidKY
000000054339OtherINANTHEM IN
36649630'0OtherINBLACK LUNG

Other names 1

  • HARRISON COUNTY EMS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060105000435 IN Part A Provider - Critical Access Hospital 9032007208 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Corydon, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073620001. Details of each certification follow.

Hospital certification: CCN 151331

Legal name
HARRISON COUNTY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Dec 15, 2005
Last certification
Jul 3, 2017
Beds
25
Ownership / control type
Local
Organization structure
OtherNon-profit
Enrollment address
1141 Hospital Drive NW
Corydon, IN 47112-2164

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

Other NPIs on the same Medicare enrollment 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Harrison County HospitalCCN 151331 · All quality measures
Overall star rating
3 of 5
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Richard D Brown Individual Other Feb 18, 2022
Harris Whitis Individual Other Jun 1, 2021
Judy Hess Individual Other Jan 1, 2016 100%
Charles Wiley Individual Corporate OfficerCfo May 28, 2018 100%
W-2 Managing EmployeeCfo Jun 19, 1995 100%
Mark B Wiseman Individual OtherBoard Member Jan 1, 2022
Lisa F Clunie Individual W-2 Managing EmployeeChief Executive Officer Jan 8, 2022
Larry Shickles Individual Other Feb 18, 2022
Stephen a Bodney Individual Other Feb 18, 2022
Kathy Shireman Individual Other Jan 1, 2017 100%
Tina Nichols Individual W-2 Managing EmployeePatient Account Manager Jan 23, 2023

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Affiliated clinicians 230

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

View all 230

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1073620001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471120038",
            "telephone_number": "812-738-4251",
            "fax_number": "812-738-7833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 HOSPITAL DR NW",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471122164",
            "telephone_number": "812-738-4251",
            "fax_number": "812-738-7833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRISON COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "DUVAL",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "812-734-3861"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IN",
            "license": "05005073-1",
            "primary": false
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IN",
            "license": "06-004773-1",
            "primary": false
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IN",
            "license": "0325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01340306",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100128260A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1065774",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM IN",
            "identifier": "000000054339",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "36649630'0",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HARRISON COUNTY EMS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HARRISON COUNTY EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corydon, IN

Sources for this page

Verify at the official NPI Registry.