NPIMap

Organization Active NPI

Marion General Hospital

  • Family Medicine Physician
  • Fairmount, IN
National Provider Identifier
1154474542
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MARION GENERAL HOSPITAL
Practice address
157 W 8TH St
Fairmount, IN 46928-1012
Phone
(765) 660-7880
Fax
(765) 382-4490
NPI assigned
Jan 19, 2007
Organization subpart
Yes
Parent organization
MARION GENERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Authorized official

Name
Stephanie Hilton-Siebert
Title
President/Ceo
Phone
(765) 660-7005

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

157 W 8TH St
Fairmount, IN 46928-1012

Mailing address

330 N Wabash
Ste G0
Marion, IN 46952-2600
Phone (765) 660-7600

Other identifiers 1

IdentifierTypeStateIssuer
100269250MedicaidIN

Other names 1

  • Fairmount Medical Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040524001483 IN Part B Supplier - Clinic/Group Practice 9133023625 Receives reassigned benefits from 139 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Marion, IN; Swayzee, IN; Gas City, IN; Fairmount, IN; Converse, IN

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
Phys Practice of MGH19 organizations share this tax ID, including this one
Part of
Phys Practice of MGH

Other organizations with this tax ID 18

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

View all 18

Locations

330 N Wabash Ave
Ste G0
Marion, IN 46952

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592265600000",
    "number": "1154474542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N WABASH",
            "address_2": "STE G0",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522600",
            "telephone_number": "765-660-7600",
            "fax_number": "765-651-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 W 8TH ST",
            "city": "FAIRMOUNT",
            "state": "IN",
            "postal_code": "469281012",
            "telephone_number": "765-660-7880",
            "fax_number": "765-382-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARION GENERAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARION GENERAL HOSPITAL",
        "enumeration_date": "2007-01-19",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A",
        "authorized_official_last_name": "HILTON-SIEBERT",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "765-660-7005"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100269250",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairmount Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fairmount Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairmount, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.