Indianapolis Jewish Home, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

INDIANAPOLIS JEWISH HOME, INC.

Practice address

7001 Hooverwood Rd
Indianapolis, IN 46260

Phone

(317) 251-2261

NPI assigned

Jan 11, 2021

Organization subpart

No

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

Authorized official

Name

Shannon Durham, RN

Title

VP of Clinical Operations

Phone

(317) 251-2261

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Aaron-Ruben-Nelson Hospice Doing business as

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Hospice certification: CCN 151646

Legal name

INDIANAPOLIS JEWISH HOME, INC.

Doing business as

AARON-RUBEN-NELSON HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

May 12, 2022

Last certification

May 12, 2022

Ownership / control type

Non-Profit - Church

Organization structure

CorporationNon-profit

Incorporated

Apr 2, 1968 in IN

Enrollment address

7001 Hoover Rd
Indianapolis, IN 46260-4169

Listed as

Aaron-Ruben-Nelson HospiceCCN 151646

Ownership

Non-Profit

Certified

May 12, 2022

Medicare certification status

ActiveFrom the Provider of Services file

All disclosed owners & managing parties 13

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

Owners & managing parties with NPI records 1

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

• Pragneshkumar N Radadiya, MD

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1548421985

  Contracted Managing Employee

  CMS ownership

All facility ownership & control disclosures 1

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

Owned or controlled facilities with NPI records 1

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

• Hancock Regional Hospital

  • Skilled Nursing Facility
  • Indianapolis, IN
  • NPI 1912939315

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 1

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

• Hancock Regional Hospital

  • Skilled Nursing Facility
  • Indianapolis, IN
  • NPI 1912939315

  Indianapolis Jewish Home, Inc.

  CMS ownership

Affiliated clinicians 1

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

• Pragneshkumar N Radadiya, MD

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1548421985

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639094400000",
    "number": "1265021695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7001 HOOVERWOOD RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46260",
            "telephone_number": "317-251-2261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7001 HOOVERWOOD RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46260",
            "telephone_number": "317-251-2261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANAPOLIS JEWISH HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A",
        "authorized_official_last_name": "DURHAM",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "VP OF CLINICAL OPERATIONS",
        "authorized_official_telephone_number": "317-251-2261",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "163WH1000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Hospice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912939315",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdurham@hooverwood.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7001 hooverwood rd",
            "city": "indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46260",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdurham@hooverwood.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7001 hooverwood rd",
            "city": "indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Aaron-Ruben-Nelson Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.