NPIMap

Organization Active NPI

St. Vincent Medical Group, Inc.

Doing business as Ascension Medical Group St. Vincent

  • Orthopaedic Surgery Physician
  • Winchester, IN
National Provider Identifier
1144513375
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ST. VINCENT MEDICAL GROUP, INC.
Doing business as
Ascension Medical Group St. Vincent
Practice address
409 E Greenville Ave
Winchester, IN 47394-9436
Phone
(765) 584-0251
NPI assigned
May 20, 2011
Last updated
Feb 6, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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

Authorized official

Name
Brian Morris
Title
Cfo
Phone
(317) 338-6234

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Family Nurse Practitioner 363LF0000X NU
Anesthesiology Physician 207L00000X NU
Dermatology Physician 207N00000X NU
Emergency Medicine Physician 207P00000X NU
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Cardiovascular Disease Physician 207RC0000X NU
Obstetrics & Gynecology Physician 207V00000X NU
Orthopaedic Surgery Physician 207X00000X NU Primary
Pediatrics Physician 208000000X NU
Surgery Physician 208600000X NU
Vascular Surgery Physician 2086S0129X NU
General Practice Physician 208D00000X NU
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X NU

Addresses

Primary practice location

409 E Greenville Ave
Winchester, IN 47394-9436

Mailing address

250 W 96TH St Ste 520
Indianapolis, IN 46260-1317

Other names 1

  • Ascension Medical Group St. Vincent Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100609000045 IN Part B Supplier - Clinic/Group Practice 7012047640 Receives reassigned benefits from 998 practitioners
9 other NPIs on this enrollment

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory

Locations

1931 Brown St
Anderson, IN 46016
Phone (765) 644-1225

4778 S Scatterfield Rd
Anderson, IN 46013
Phone (765) 646-6331

10590 N Meridian St
Ste 105
Carmel, IN 46290
Phone (317) 583-7800

12188A N Meridian St
Ste 375
Carmel, IN 46032

13250 Hazel Dell Pkwy
Ste 104
Carmel, IN 46033
Phone (317) 415-6117

13420 N Meridian St
Ste 420
Carmel, IN 46032
Phone (317) 582-8500

13450 N Meridian St
Ste 145
Carmel, IN 46032
Phone (317) 338-4303

310 Medical Dr
Ste 102
Carmel, IN 46032
Phone (317) 415-5960

13914 Southeastern Pkwy
Ste 110
Fishers, IN 46037
Phone (317) 415-9010

13914 Southeastern Pkwy
Ste 302
Fishers, IN 46037
Phone (317) 415-5795

8091 Township Line Rd
Ste 105
Indianapolis, IN 46260
Phone (317) 415-8050

8333 Naab Rd
Ste 230
Indianapolis, IN 46260
Phone (317) 415-6580

8414 Naab Rd
Indianapolis, IN 46260
Phone (317) 338-1600

8424 Naab Rd
Ste 2A
Indianapolis, IN 46260
Phone (317) 415-6300

186 E Southway Blvd
Kokomo, IN 46902
Phone (765) 236-8299

1907 W Sycamore St
Fl 3
Kokomo, IN 46901
Phone (765) 236-8300

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ascension Medical Group St. VincentWinchester, IN, CCN 153881 Rural health clinic Operational/Managerial Control Jul 1, 2012
Ascension Medical Group St. VincentNorth Vernon, IN, CCN 153887 Rural health clinic Operational/Managerial Control Jul 1, 2012
Ascension Medical Group St. VincentUnion City, IN, CCN 153879 Rural health clinic Operational/Managerial Control Jul 1, 2012

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 1,002

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.

View all 1,002

NPI Registry JSON

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

{
    "created_epoch": "1305849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580947200000",
    "number": "1144513375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W 96TH ST STE 520",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 E GREENVILLE AVE",
            "city": "WINCHESTER",
            "state": "IN",
            "postal_code": "473949436",
            "telephone_number": "765-584-0251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VINCENT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-20",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "317-338-6234"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension Medical Group St. Vincent",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winchester, IN

Sources for this page

Verify at the official NPI Registry.