NPIMap

Organization Active NPI

Daviess County Hospital

  • Rural Health Clinic/Center
  • Washington, IN
National Provider Identifier
1356468631
Registry record updated Jan 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
DAVIESS COUNTY HOSPITAL
Practice address
1402 Grand Ave
Washington, IN 47501-2122
Phone
(812) 257-0383
Fax
(812) 257-0433
NPI assigned
Mar 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2021

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

Authorized official

Name
Mr. Anthony Showalter
Title
President of the Board of Directors
Phone
(812) 254-8620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1402 Grand Ave
Washington, IN 47501-2122

Mailing address

1402 Grand Ave
Washington, IN 47501-2122
Phone (812) 257-0383

Other identifiers 1

IdentifierTypeStateIssuer
100270240CMedicaidIN

Other names 1

  • Grand Avenue Pediatrics Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dchdirect@direct.dchsystem.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070424000017 IN Part A Provider - Rural Health Clinic 1557271665 Practice locations: Washington, IN

Rural health clinic certification: CCN 158503

Legal name
DAVIESS COUNTY HOSPITAL
Doing business as
GRAND AVENUE PEDIATRICS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 27, 2005
Last certification
Nov 7, 2024
Ownership / control type
1B
Organization structure
GovernmentNon-profit
Incorporated
Jun 19, 1913 in IN
Enrollment address
1402 Grand Ave
Washington, IN 47501-2122
Related CCNs
150061

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

National Provider Directory

National Provider Directory
Tax ID family
Tammy Ziegler CNP44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Michelle Deem Individual Corporate Director Oct 13, 2014
Tyson Wagler Individual Corporate Director Jun 18, 2013
Daviess County Hospital Organization, Washington, IN Operational/Managerial Control Nov 4, 2014
Larry Wilson Individual Corporate Director Oct 13, 2014
Chastity L Fox Individual W-2 Managing Employee May 5, 2014
Julie a Stephens Individual W-2 Managing Employee May 5, 2014
Daniel McCarthy Individual Corporate Director Oct 13, 2014
Deron Steiner Individual Corporate Director Jun 18, 2013
Joann Arthur Individual Corporate Director Jun 18, 2013
Anthony Showalter Individual Corporate Director Jun 18, 2013
Jeannie Burks Individual Corporate Director Oct 13, 2014
Steven Myers Individual Corporate Director Jun 18, 2013

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 26

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

FacilityTypeRoleSince
Daviess Community HospitalWashington, IN, CCN 150061 Hospital Operational/Managerial Control Nov 4, 2014
Autumn Woods Health CampusNew Albany, IN, CCN 155681 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Dec 1, 2014
Dec 1, 2014
Hearthstone Health CampusBloomington, IN, CCN 155818 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Dec 1, 2014
Dec 1, 2014
Dec 1, 2014
Hampton Oaks Health CampusScottsburg, IN, CCN 155753 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 May 1, 2015
May 1, 2015
May 1, 2015
Newburgh Health CareNewburgh, IN, CCN 155354 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2015
Stonecroft Health CampusBloomington, IN, CCN 155838 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Sep 1, 2015
Sep 1, 2015
Sep 1, 2015
The Villages at Oak RidgeWashington, IN, CCN 155837 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Aug 1, 2015
Dec 1, 2014
Dec 1, 2014
Beaumont Healthcare and Rehabilitation CenterAnderson, IN, CCN 155005 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Feb 1, 2016
Feb 1, 2016
Feb 1, 2016
Charleston Place at New AlbanyNew Albany, IN, CCN 155668 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Aug 1, 2016
Laurels of DekalbButler, IN, CCN 155386 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2016
Majestic Care of SheridanSheridan, IN, CCN 155376 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Aug 1, 2016
Aug 1, 2016
Jul 3, 2025
Majestic Care of North VernonNorth Vernon, IN, CCN 155665 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Aug 1, 2016
Aug 1, 2016
Apr 3, 2025
Majestic Care of Fort WayneFort Wayne, IN, CCN 155359 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Aug 1, 2016
Aug 1, 2016
Jul 7, 2025
Majestic Care of ConnersvilleConnersville, IN, CCN 155491 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Aug 1, 2016
Aug 1, 2016
Jul 1, 2025
Premier Healthcare of New HarmonyNew Harmony, IN, CCN 155370 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Aperion Care SummerfieldCloverdale, IN, CCN 155587 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2017
Aperion Care VincennesVincennes, IN, CCN 155042 Skilled nursing facility 5% Or Greater Direct Ownership Interest Jan 1, 2017
Aperion Care MonroeBloomington, IN, CCN 155532 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2017
Aperion Care GreenfieldGreenfield, IN, CCN 155254 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2017
Aperion Care LincolnEvansville, IN, CCN 155820 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2017
Aperion Care HanoverHanover, IN, CCN 155208 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018
The Restoracy of GoshenGoshen, IN, CCN 155856 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Jun 1, 2021
Oct 10, 2024
Oct 24, 2024
Daviess County HospitalWashington, IN, CCN 151553 Hospice Operational/Managerial Control Mar 11, 2015
DCH Health PavilionWashington, IN, CCN 158501 Rural health clinic Operational/Managerial Control Mar 6, 1989
DCH Medical ClinicWashington, IN, CCN 158500 Rural health clinic Other Apr 2, 2015
DCH Montgomery Medical ClinicMontgomery, IN, CCN 158593 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2025

Facilities with the same owner 25

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

View all 25

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609545600000",
    "number": "1356468631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 GRAND AVE",
            "city": "WASHINGTON",
            "state": "IN",
            "postal_code": "475012122",
            "telephone_number": "812-257-0383",
            "fax_number": "812-257-0433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 GRAND AVE",
            "city": "WASHINGTON",
            "state": "IN",
            "postal_code": "475012122",
            "telephone_number": "812-257-0383",
            "fax_number": "812-257-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIESS COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2021-01-02",
        "certification_date": "2021-01-02",
        "status": "A",
        "authorized_official_last_name": "SHOWALTER",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT OF THE BOARD OF DIRECTORS",
        "authorized_official_telephone_number": "812-254-8620",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100270240C",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dchdirect@direct.dchsystem.com",
            "affiliation": "N",
            "address_1": "421 E Van Trees St",
            "city": "Washington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "475012948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Grand Avenue Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Grand Avenue Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Washington, IN

Sources for this page

Verify at the official NPI Registry.