NPIMap

Organization Active NPI

St Marys Health, Inc.

Doing business as Ascension St. Vincent Evansville

  • Psychiatric Hospital Unit
  • Evansville, IN
National Provider Identifier
1285732933
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
05-0050891 Issued in IN
Legal business name
ST MARYS HEALTH, INC.
Doing business as
Ascension St. Vincent Evansville
St. Vincent Evansville
Practice address
3700 Washington Ave
Evansville, IN 47750-0001
Phone
(812) 485-4000
Fax
(812) 485-6839
NPI assigned
Sep 20, 2006
Last updated
Jun 29, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Authorized official

Name
Mr. Dennis Keith Jewell, CPA
Title
Ceo
Phone
(812) 485-1508

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 05-0050891 IN Primary

Addresses

Primary practice location

3700 Washington Ave
Evansville, IN 47750-0001

Mailing address

3700 Washington Ave
Evansville, IN 47750-0001
Phone (812) 485-4000

Other names 2

  • Ascension St. Vincent Evansville Doing business as
  • St. Vincent Evansville Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071121000007 IN Part A Provider - Hospital 9133023898 Practice locations: Evansville, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285732933. Details of each certification follow.

Hospital certification: CCN 15S100

Legal name
ST MARYS HEALTH INC
Doing business as
ASCENSION ST. VINCENT EVANSVILLE
Organization structure
CorporationNon-profit
Incorporated
May 22, 1941 in IN
Enrollment address
3700 Washington Ave
Evansville, IN 47714-0541
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

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

Other NPIs with the same Medicare PAC ID 10

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

National Provider Directory

National Provider Directory

Ownership & related parties

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.

NameRoleSinceShare
Terrence G Metzger Individual Corporate DirectorBoard Member Jul 1, 2022
Alexander Chang Individual Corporate OfficerPresident Jul 1, 2022
W-2 Managing EmployeePresident Jul 1, 2022
Johnathan Pope Individual Corporate DirectorBoard Member Jul 1, 2022
Ernest L Johnson Individual Corporate DirectorBoard Member Jul 1, 2014
Jonathan S Nalli Individual Corporate OfficerHome Office President and Ceo Mar 1, 2018
Tricia M Hollander-Henning Individual Corporate DirectorBoard Member Jul 1, 2022
Michael a Herrell Individual Corporate DirectorBoard Member Jul 1, 2019
James Sandgren Individual Corporate DirectorBoard Member Mar 1, 2017
Brian Schymik Individual Corporate DirectorBoard Member Mar 1, 2017
Rita P Eykamp Individual Corporate DirectorBoard Member Jul 1, 2014
St Vincent Health Inc Organization, Indianapolis, IN Non-profit 5% Or Greater Direct Ownership Interest Oct 1, 2014 100%
Operational/Managerial Control Oct 1, 2014 100%
Kevin Valadares Individual Corporate DirectorBoard Member Jul 1, 2022
Sally G Rideout Individual Corporate DirectorBoard Member Oct 1, 2014

Owners & managing parties with NPI records 1

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

Facilities with the same owner 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593388800000",
    "number": "1285732933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 WASHINGTON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477500001",
            "telephone_number": "812-485-4000",
            "fax_number": "812-485-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 WASHINGTON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477500001",
            "telephone_number": "812-485-4000",
            "fax_number": "812-485-6839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARYS HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A",
        "authorized_official_last_name": "JEWELL",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-485-1508",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "IN",
            "license": "05-0050891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension St. Vincent Evansville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Vincent Evansville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.