NPIMap

Organization Active NPI

St Vincent Salem Hospital Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Salem, IN
National Provider Identifier
1245560705
Registry record updated Oct 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
ST VINCENT SALEM HOSPITAL INC
Practice address
911 N Shelby St
Salem, IN 47167-2304
Phone
(812) 883-5881
Fax
(812) 883-8563
NPI assigned
Jan 6, 2010
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Lee Z Jaeger
Title
Ceo
Phone
(812) 883-8550

Owners & managing parties with NPI records 1

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

Owned or controlled facilities with NPI records 1

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

Other NPIs with the same Medicare PAC ID 1

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

Corporate family (same tax ID) 1

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

Facilities connected through Provider of Services related, parent or unit certification numbers.

Facilities with the same owner 166

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

View all 166

Affiliated clinicians 2

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

Medicare participation

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

Hospital certification: CCN 15Z314

Medicare enrollment files
Legal name
ST VINCENT SALEM HOSPITAL INC
Doing business as
ASCENSION ST VINCENT SALEM HOSPITAL SWING BED
Organization structure
CorporationNon-profit
Incorporated
Aug 28, 2009 in IN
Enrollment address
911 N Shelby St
Salem, IN 47167-2304
Hospital Swing-Bed Unit

All disclosed owners & managing parties 12

Medicare enrollment files

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

NameRoleSinceShare
Jacob Steve Baker Individual Corporate DirectorBoard Member Jul 1, 2023
Kevin P Speer Individual Corporate OfficerHome Office - President & Ceo May 1, 2023
Cynthia Dawn Adams Individual Corporate DirectorBoard Member Jul 1, 2023
Carlyle Floyd Individual Corporate DirectorBoard Member Jul 1, 2023
Floyd Grubb Individual Corporate DirectorBoard Member Jul 1, 2023
Michael Todd Emmons Individual Corporate DirectorBoard Member Jul 1, 2023
Dana M Muntz Individual Corporate OfficerVP of Rural Healthcare Jul 1, 2023
Corporate DirectorBoard Member Jul 1, 2023
W-2 Managing EmployeeVP of Rural Healthcare Jul 1, 2023
Brian Edwards Individual Corporate DirectorBoard Member Jul 1, 2023
Donna Cassidy Individual Corporate OfficerAdministrator Jul 1, 2021
W-2 Managing EmployeeAdministrator Jul 1, 2021
Ascension Health Organization, Saint Louis, MO Non-profit Operational/Managerial Control Aug 28, 2009
St Vincent Health Inc Organization, Indianapolis, IN Non-profit Operational/Managerial Control Aug 28, 2009 100%
Ryan Penrod Individual Corporate DirectorBoard Member Jul 1, 2023

All facility ownership & control disclosures 1

Medicare enrollment files

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

FacilityTypeRoleSince
Ascension St Vincent SalemSalem, IN, CCN 151314 Hospital 5% Or Greater Direct Ownership Interest (100%) Aug 28, 2009

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20100302000540 IN Part a Provider - Critical Access Hospital 6507901501 Practice locations: Salem, IN

National Provider Directory

National Provider Directory
Tax ID family
St Vincent Salem Hospital (2 organizations share this tax ID)

Locations

911 N Shelby St
Salem, IN 47167
Phone (812) 883-5881

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

911 N Shelby St
Salem, IN 47167-2304

Mailing address

911 N Shelby St
Salem, IN 47167-2304
Phone (812) 883-5881

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 10, 2012.

{
    "created_epoch": "1262736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349827200000",
    "number": "1245560705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 N SHELBY ST",
            "city": "SALEM",
            "state": "IN",
            "postal_code": "471672304",
            "telephone_number": "812-883-5881",
            "fax_number": "812-883-8563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 N SHELBY ST",
            "city": "SALEM",
            "state": "IN",
            "postal_code": "471672304",
            "telephone_number": "812-883-5881",
            "fax_number": "812-883-8563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST VINCENT SALEM HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-06",
        "last_updated": "2012-10-10",
        "status": "A",
        "authorized_official_last_name": "JAEGER",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-883-8550",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, IN

Sources for this page

Verify at the official NPI Registry.