NPIMap

Organization Active NPI

Marion General Hospital

Doing business as Pediatric Center

  • Pediatrics Physician
  • Marion, IN
National Provider Identifier
1346393204
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MARION GENERAL HOSPITAL
Doing business as
Pediatric Center
Practice address
330 N Wabash Ave
Suite 320
Marion, IN 46952-2779
Phone
(765) 660-7660
Fax
(765) 671-3502
NPI assigned
Jan 22, 2007
Last updated
Jun 16, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
MARION GENERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Authorized official

Name
Stephanie Hilton-Siebert, FACHE, CPA, FHFMA
Title
President/Ceo
Phone
(765) 662-4776

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

330 N Wabash Ave
Suite 320
Marion, IN 46952-2779

Mailing address

330 N Wabash
Ste G20
Marion, IN 46952-2600
Phone (765) 660-7600

Other identifiers 1

IdentifierTypeStateIssuer
100269250MedicaidIN

Other names 1

  • Pediatric Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040524001483 IN Part B Supplier - Clinic/Group Practice 9133023625 Receives reassigned benefits from 139 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Marion, IN; Swayzee, IN; Gas City, IN; Fairmount, IN; Converse, IN

Other NPIs on the same Medicare enrollment 7

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
15D0891980Dba Pediatric Center330 N Wabash Ave Ste 320, Marion, IN 46952Certificate of waiverMar 31, 2028

National Provider Directory

National Provider Directory
Part of
Jeffrey D Breckenridge

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592265600000",
    "number": "1346393204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N WABASH",
            "address_2": "STE G20",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522600",
            "telephone_number": "765-660-7600",
            "fax_number": "765-651-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N WABASH AVE",
            "address_2": "SUITE 320",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522779",
            "telephone_number": "765-660-7660",
            "fax_number": "765-671-3502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARION GENERAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARION GENERAL HOSPITAL",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A",
        "authorized_official_last_name": "HILTON-SIEBERT",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "765-662-4776",
        "authorized_official_credential": "FACHE, CPA, FHFMA"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100269250",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pediatric Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marion, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.