Hendricks County Hospital
Organization Active NPI Internal Medicine Physician · Danville, IN
NPI 1174620488 · NPPES record last updated May 28, 2024
Key facts
- NPI
- 1174620488
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- HENDRICKS COUNTY HOSPITAL
- Practice address
- 100 Hospital LN
Suite 115
Danville, IN 46122-1989 - Phone
- (317) 718-4066
- Fax
- (317) 718-4076
- NPI assigned
- Sep 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Heather Rutherford
- Title
- Credentialing Coordinator
- Phone
- (317) 837-5566
Corporate family (same tax ID) 24
Practitioners 6
-
Jennifer L Allen, M.D.
-
Timothy Fred Benge, PA-C
-
Beth Summers, M.D.
-
Mark A. Booher, M.D.
-
John Champley, M.D.
-
Bradley P Hamrick, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D0956569 | Internal Medicine of Hendricks County | Certificate of waiver | Jan 30, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040811000309 | IN | Part B Supplier - Clinic/Group Practice | 4880505528 |
Receives reassigned benefits from 431 practitioners This NPI is an additional NPI on the enrollment Practice locations: Brownsburg, IN; Danville, IN; Greencastle, IN; Lizton, IN; Plainfield, IN; Avon, IN; Bainbridge, IN |
National Provider Directory
- Tax ID family
- Hendricks Community Hosp
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
100 Hospital LN
Suite 115
Danville, IN 46122-1989
Mailing address
1100 Southfield Dr
Suite 1370
Plainfield, IN 46168-4498
Phone (317) 837-5571
Other names
- Internal Medicine of Hendricks County
Other providers in Danville, IN
- Hendricks County Hospital
- Hendricks County Hospital
- Hendricks County Hospital
- Hendricks County Hospital
- Hendricks County Hospital
- Hendricks County Hospital
- Hendricks County Hospital
- Hendricks County Hospital
- Hendricks County Hospital
- Hendricks County Hospital
All providers in Danville, IN · Internal Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2024. 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.