NPIMap

Organization Active NPI

Union Hospital Inc.

Doing business as Clay City Center for Family Medicine

  • Rural Health Clinic/Center
  • Clay City, IN
National Provider Identifier
1235120882
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
UNION HOSPITAL INC.
Doing business as
Clay City Center for Family Medicine
Practice address
315 Lankford St
Clay City, IN 47841-1008
Phone
(812) 939-2126
NPI assigned
Nov 2, 2005
Last updated
Jul 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Authorized official

Name
Steve Holman
Title
Ceo
Phone
(812) 238-7606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

315 Lankford St
Clay City, IN 47841-1008

Mailing address

PO Box 2505
Indianapolis, IN 46206-2505
Phone (812) 238-7783

Other identifiers 1

IdentifierTypeStateIssuer
100079350MedicaidIN

Other names 1

  • Clay City Center for Family Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040519000807 IN Part B Supplier - Clinic/Group Practice 8426943614 Receives reassigned benefits from 126 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Terre Haute, IN; W Terre Haute, IN; Brazil, IN; Clay City, IN; Clinton, IN; Greencastle, IN; Riley, IN; Rockville, IN…
O20070626000727 IN Part A Provider - Rural Health Clinic 8426943614 Practice locations: Clay City, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1235120882. Details of each certification follow.

Rural health clinic certification: CCN 153804

Legal name
UNION HOSPITAL INC
Doing business as
CLAY CITY CENTER FOR FAMILY MEDICINE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 10, 1993
Last certification
Jun 11, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
May 6, 1895 in IN
Enrollment address
315 Lankford St
Clay City, IN 47841-1008

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 10

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0868139Clay City Center for Family Medicine315 Lankford St, Clay City, IN 47841Certificate of waiverAug 10, 2027

National Provider Directory

National Provider Directory

Locations

315 Lankford St
Clay City, IN 47841
Phone (812) 939-2126

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
John Aidoo Individual Corporate DirectorBoard Member Jan 1, 2021
Mary Doti Individual Corporate DirectorBoard Member Jan 1, 2018
Tim Sullivan Individual Corporate DirectorBoard Member Jan 1, 2021
Robert a Coons Individual Corporate OfficerVice Chairman Jan 1, 2021
Corporate DirectorBoard Member Oct 24, 2014
John C Etling Individual Corporate DirectorBoard Member Jan 1, 2019
Kenneth M Kigorwe Individual OtherBoard Member Jan 1, 2023
Luke Terry Individual Corporate OfficerTreasurer Jan 1, 2021
Corporate DirectorBoard Member Jan 1, 2021
Kathleen D Coutinho Individual Corporate OfficerBoard Member Jan 1, 2019
Donald T Scott Individual Corporate OfficerChairman Jan 1, 2021
Corporate DirectorBoard Member Oct 23, 2014
Steven M Holman Individual Corporate OfficerPresident and Ceo Apr 30, 2014
W-2 Managing EmployeePresident & Ceo Apr 30, 2014
Richard Templeton Individual OtherBoard Member Jan 1, 2024
Sara D Smith Individual Corporate OfficerSecretary Jan 1, 2021
Corporate DirectorBoard Member Oct 23, 2014
Molly a Callahan Individual Corporate DirectorBoard Member Oct 1, 2005
Union Hospital Inc Organization, Terre Haute, IN Non-profit 5% Or Greater Direct Ownership Interest Dec 10, 1993 100%

Owners & managing parties with NPI records 10

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

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Union Hospital ClintonClinton, IN, CCN 151326 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 27, 2005
Union Hospital IncTerre Haute, IN, CCN 150023 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Union Hospital Medical Rehabilitation UnitTerre Haute, IN, CCN 15T023 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 1, 1989
Union Hospital ClintonClinton, IN, CCN 15Z326 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 27, 2005
Union Hospital IncTerre Haute, IN, CCN 15S023 Hospital 5% Or Greater Indirect Ownership Interest Jan 1, 1966
Cork Medical CenterMarshall, IL, CCN 148987 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2001
Brazil Family MedicineBrazil, IN, CCN 153869 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Sep 30, 2016

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 7

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689811200000",
    "number": "1235120882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2505",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462062505",
            "telephone_number": "812-238-7783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 LANKFORD ST",
            "city": "CLAY CITY",
            "state": "IN",
            "postal_code": "478411008",
            "telephone_number": "812-939-2126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNION HOSPITAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-02",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A",
        "authorized_official_last_name": "HOLMAN",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-238-7606"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100079350",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clay City Center for Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clay City Center for Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clay City, IN

Sources for this page

Verify at the official NPI Registry.