NPIMap

Organization Active NPI

State of Indiana Auditor of State

Doing business as Evansville State Hospital

  • Intellectual Disabilities Intermediate Care Facility
  • Evansville, IN
National Provider Identifier
1326169871
Registry record updated Aug 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
STATE OF INDIANA AUDITOR OF STATE
Doing business as
Evansville State Hospital
Practice address
3400 Lincoln Avenue
Evansville, IN 47714
Phone
(812) 469-6800
Fax
(812) 469-6847
NPI assigned
Apr 3, 2007
Last updated
Aug 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2010

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

Authorized official

Name
Cathe Fulcher
Title
Superintendent
Phone
(812) 469-6800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

3400 Lincoln Avenue
Evansville, IN 47714

Mailing address

3400 Lincoln Avenue
Evansville, IN 47714
Phone (812) 469-6800

Other identifiers 1

IdentifierTypeStateIssuer
100272090MedicaidIN

Other names 1

  • Evansville State Hospital Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Indiana State Department of32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283126400000",
    "number": "1326169871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 LINCOLN AVENUE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47714",
            "telephone_number": "812-469-6800",
            "fax_number": "812-469-6847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 LINCOLN AVENUE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47714",
            "telephone_number": "812-469-6800",
            "fax_number": "812-469-6847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF INDIANA AUDITOR OF STATE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2010-08-30",
        "status": "A",
        "authorized_official_last_name": "FULCHER",
        "authorized_official_first_name": "CATHE",
        "authorized_official_title_or_position": "SUPERINTENDENT",
        "authorized_official_telephone_number": "812-469-6800"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100272090",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evansville State Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2010; 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.