Organization Active NPI

Saint John Health System

  • Durable Medical Equipment & Medical Supplies
  • Indianapolis, IN
National Provider Identifier
1215087002
Registry record updated Dec 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
69000167A Issued in IN
Legal business name
SAINT JOHN HEALTH SYSTEM
Practice address
8401 Harcourt Rd
#3011
Indianapolis, IN 46260-2036
Phone
(317) 338-4803
Fax
(317) 338-4917
NPI assigned
Jan 12, 2007
Organization subpart
Yes
Parent organization
ST.VINCENT MADISON COUNTY HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 20, 2011

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

Authorized official

Name
Mr. Dante O Phillips
Title
Director
Phone
(765) 683-3201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 69000167A IN Primary

Addresses

Primary practice location

8401 Harcourt Rd
#3011
Indianapolis, IN 46260-2036

Mailing address

2015 Jackson St
RM 248
Anderson, IN 46016-4337
Phone (765) 683-3201

Other identifiers 1

IdentifierTypeStateIssuer
200408950AMedicaidIN

Other names 1

  • Saint Johns Medical Supplies Doing business as

National Provider Directory

National Provider Directory
Part of
Patrick M McGill MD

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

8401 Harcourt Rd
#3011
Indianapolis, IN 46260
Phone (317) 338-4803

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324339200000",
    "number": "1215087002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 JACKSON ST",
            "address_2": "RM 248",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460164337",
            "telephone_number": "765-683-3201",
            "fax_number": "765-646-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 HARCOURT RD",
            "address_2": "#3011",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602036",
            "telephone_number": "317-338-4803",
            "fax_number": "317-338-4917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT JOHN HEALTH SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST.VINCENT MADISON COUNTY HEALTH SYSTEM",
        "enumeration_date": "2007-01-12",
        "last_updated": "2011-12-20",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "DANTE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "765-683-3201",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IN",
            "license": "69000167A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200408950A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saint Johns Medical Supplies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.