NPIMap

Organization Active NPI

Putnam County Hospital

Doing business as Johnson Nichols Health Clinic

  • Health Service Clinic/Center
  • Greencastle, IN
National Provider Identifier
1114438579
Registry record updated Feb 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
PUTNAM COUNTY HOSPITAL
Doing business as
Johnson Nichols Health Clinic
Practice address
1542 S Bloomington St
Greencastle, IN 46135-2212
Phone
(765) 653-6171
NPI assigned
Oct 12, 2017
Last updated
Feb 15, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2018

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

Authorized official

Name
Roger S Boruff
Title
Authorized Official
Phone
(765) 655-2620

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Surgical Family Planning Clinic/Center 261QF0050X
Health Service Clinic/Center 261QH0100X Primary

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 1

  • Johnson Nichols Health Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 7

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0352745Johnson Nichols Health Clinic1542 S Bloomington St, Greencastle, IN 46135Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Putnam County Hosp26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

141 Martinsville St
Greencastle, IN 46135
Phone (765) 653-6171

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1507766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518652800000",
    "number": "1114438579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1542 S BLOOMINGTON ST",
            "city": "GREENCASTLE",
            "state": "IN",
            "postal_code": "461352212",
            "telephone_number": "765-653-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 S BLOOMINGTON ST",
            "city": "GREENCASTLE",
            "state": "IN",
            "postal_code": "461352212",
            "telephone_number": "765-653-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUTNAM COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-12",
        "last_updated": "2018-02-15",
        "status": "A",
        "authorized_official_last_name": "BORUFF",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "765-655-2620"
    },
    "taxonomies": [
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Johnson Nichols Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greencastle, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.