Putnam County Hospital
Organization Active NPI Health Service Clinic/Center · Greencastle, IN
NPI 1114438579 · NPPES record last updated Feb 15, 2018
Key facts
- NPI
- 1114438579
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Health Service Clinic/Center 261QH0100X
- Legal business name
- PUTNAM COUNTY HOSPITAL
- Practice address
- 1542 S Bloomington St
Greencastle, IN 46135-2212 - Phone
- (765) 653-6171
- NPI assigned
- Oct 12, 2017
- Organization subpart
- No
Authorized official
- Name
- Roger S Boruff
- Title
- Authorized Official
- Phone
- (765) 655-2620
Other NPIs on the same Medicare enrollment 7
Corporate family (same tax ID) 25
Practitioners 11
-
Terence M Grogan, DO
-
Lisa Lynn Martin, M.D.
-
Troy Tolosa Quiz, M.D.
-
Katie N Rowland, FNP-BC
-
Bridget Rund, NP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D0352745 | Johnson Nichols Health Clinic | Provider-performed microscopy | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040420000945 | IN | Part B Supplier - Clinic/Group Practice | 1951396605 |
Receives reassigned benefits from 94 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bainbridge, IN; Cloverdale, IN; Green Castle, IN; Greencastle, IN |
National Provider Directory
- Tax ID family
- Putnam Surgical Special
Locations
51 E Market St
Cloverdale, IN 46120
Phone (765) 795-4242
390 Erie Ave
Ste A
Connersville, IN 47331
Phone (812) 325-7492
141 Martinsville St
Greencastle, IN 46135
Phone (765) 653-2018
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Non-Surgical Family Planning Clinic/Center | 261QF0050X | |||
| Health Service Clinic/Center | 261QH0100X | Yes |
Addresses
Primary practice location
1542 S Bloomington St
Greencastle, IN 46135-2212
Mailing address
1542 S Bloomington St
Greencastle, IN 46135-2212
Phone (765) 653-6171
Other names
- Johnson Nichols Health Clinic
Other providers in Greencastle, IN
- Putnam County Comprehensive Service
- Putnam County Comprehensive Service
- Putnam County Comprehensive Services
- Putnam County EMS
- Putnam County Hospital
- Putnam County Hospital
- Putnam County Hospital
- Putnam County Hospital
- Putnam County Hospital
- Putnam County Hospital
All providers in Greencastle, IN · Health Service Clinic/Center in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2018. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.