Decatur County Memorial Hospital

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

DECATUR COUNTY MEMORIAL HOSPITAL

Doing business as

Westport Clinic

Practice address

308 E Mulberry St
Westport, IN 47283-9369

Phone

(812) 222-3627

Fax

(812) 663-1155

NPI assigned

Jul 7, 2005

Organization subpart

No

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

Authorized official

Name

Catherine Keck

Title

Cfo

Phone

(812) 663-1172

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Westport Clinic Doing business as

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612828800000",
    "number": "1093712887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 E MULBERRY ST",
            "city": "WESTPORT",
            "state": "IN",
            "postal_code": "472839369",
            "telephone_number": "812-222-3627",
            "fax_number": "812-663-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 E MULBERRY ST",
            "city": "WESTPORT",
            "state": "IN",
            "postal_code": "472839369",
            "telephone_number": "812-222-3627",
            "fax_number": "812-663-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A",
        "authorized_official_last_name": "KECK",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "812-663-1172"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200220600B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westport Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shane Jeremy Billingsley, DT
• Jennifer Diekhoff, CRNA
• Lauren Rachel Naum, LMT
• Westport Community Volunteer Fire Department

• Primary Care Clinic/Center in Westport, IN
• Providers in Westport, IN by specialty
• Primary Care Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; 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.