Midland House, Inc.

Primary specialty

Religious Nonmedical Health Care InstitutionTaxonomy code 282J00000X

Legal business name

MIDLAND HOUSE, INC.

Practice address

3940 E 56TH St
Indianapolis, IN 46220-5541

Phone

(317) 257-2201

Fax

(317) 254-2112

NPI assigned

Feb 13, 2008

Last updated

Feb 27, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Nancy Jean Hayworth

Title

Administrator

Phone

(317) 257-2201

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194993188. Details of each certification follow.

• CCN 151992 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 151992

Legal name

MIDLAND HOUSE INC

Certification status

Terminated Voluntary: merger or closure, Jul 10, 2010

Provider type (POS)

Hospital – Religious non-medical health care institution

Participating since

Dec 30, 2003

Last certification

Sep 28, 2006

Beds

25 (18 certified)

Ownership / control type

Church

Facility address

3940 E 56TH St
Indianapolis, IN 46220

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204070400000",
    "number": "1194993188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3940 E 56TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462205541",
            "telephone_number": "317-257-2201",
            "fax_number": "317-254-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3940 E 56TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462205541",
            "telephone_number": "317-257-2201",
            "fax_number": "317-254-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDLAND HOUSE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-13",
        "last_updated": "2008-02-27",
        "status": "A",
        "authorized_official_last_name": "HAYWORTH",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "317-257-2201",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282J00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Health Care Institution",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Todd E Midla, DO
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• Religious Nonmedical Health Care Institution in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Religious Nonmedical Health Care Institution in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.