NPIMap

Organization Active NPI

Fayette Memorial Hospital Association Inc

Doing business as Fayette Regional Health System Home Health

  • Home Health Agency
  • Connersville, IN
National Provider Identifier
1093774275
Registry record updated Jul 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
050091491 Issued in IN
Legal business name
FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC
Doing business as
Fayette Regional Health System Home Health
Practice address
1941 Virginia Ave
Connersville, IN 47331-2833
Phone
(765) 825-0046
Fax
(765) 827-7783
NPI assigned
Mar 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2016

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

Authorized official

Name
Randall White
Title
Ceo
Phone
(765) 827-7987

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 050091491 IN Primary

Addresses

Primary practice location

1941 Virginia Ave
Connersville, IN 47331-2833

Mailing address

1941 Virginia Ave
Connersville, IN 47331
Phone (765) 827-7717

Other identifiers 1

IdentifierTypeStateIssuer
100263600AMedicaidIN

Other names 1

  • Fayette Regional Health System Home Health Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468454400000",
    "number": "1093774275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 VIRGINIA AVE",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "47331",
            "telephone_number": "765-827-7717",
            "fax_number": "765-827-7783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 VIRGINIA AVE",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473312833",
            "telephone_number": "765-825-0046",
            "fax_number": "765-827-7783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-17",
        "last_updated": "2016-07-14",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "765-827-7987"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IN",
            "license": "050091491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100263600A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fayette Regional Health System Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Connersville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; 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.