NPIMap

Organization Active NPI

Visiting Nurse Assoc. of the Wabash Valley,Inc.

Doing business as Hospice of the Wabash Valley

  • Community Based Hospice Care Agency
  • Terre Haute, IN
National Provider Identifier
1215077144
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
06-005127-1 Issued in IN
Legal business name
VISITING NURSE ASSOC. OF THE WABASH VALLEY,INC.
Doing business as
Hospice of the Wabash Valley
Practice address
400 8TH Ave
Terre Haute, IN 47804-4030
Phone
(812) 232-7611
Fax
(812) 232-1024
NPI assigned
Feb 8, 2007
Last updated
Dec 8, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

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

Authorized official

Name
Mrs. Trudy Rupska, RN,MS
Title
VP & Coo
Phone
(812) 232-7611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 06-005127-1 IN Primary

Addresses

Primary practice location

400 8TH Ave
Terre Haute, IN 47804-4030

Mailing address

400 8TH Ave
Terre Haute, IN 47804-4030
Phone (812) 232-7611

Other identifiers 1

IdentifierTypeStateIssuer
200142120AMedicaidIN

Other names 1

  • HOSPICE OF THE WABASH VALLEY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071231000031 IN Part A Provider - Hospice 0749370013 Practice locations: Terre Haute, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215077144. Details of each certification follow.

Hospice certification: CCN 151510

Legal name
VISITING NURSE ASSOC. OF THE WABASH VALLEY,INC.
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 31, 1991
Last certification
Dec 5, 2019
Ownership / control type
Non-Profit - Private
Organization structure
CorporationProprietary
Enrollment address
400 8TH Ave
Terre Haute, IN 47804-4030

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Hospice of the Wabash Valley IncCCN 151510 · All quality measures
Ownership
Non-Profit
Certified
May 31, 1991
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Hospice of the Wabash Valley3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1606 N 7th St
Fl 5
Terre Haute, IN 47804
Phone (812) 234-2515

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Lynn Morales Individual W-2 Managing EmployeeFinance Director Jul 11, 2011
Trudy Rupska Individual Corporate Director Nov 1, 2006
Ravi K Koduru Individual Contracted Managing EmployeeMedical Director Dec 4, 2015

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512691200000",
    "number": "1215077144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 8TH AVE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478044030",
            "telephone_number": "812-232-7611",
            "fax_number": "812-232-1024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 8TH AVE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478044030",
            "telephone_number": "812-232-7611",
            "fax_number": "812-232-1024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISITING NURSE ASSOC. OF THE WABASH VALLEY,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2017-12-08",
        "status": "A",
        "authorized_official_last_name": "RUPSKA",
        "authorized_official_first_name": "TRUDY",
        "authorized_official_title_or_position": "VP & COO",
        "authorized_official_telephone_number": "812-232-7611",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN,MS"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "IN",
            "license": "06-005127-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200142120A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HOSPICE OF THE WABASH VALLEY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.