NPIMap

Organization Active NPI

St. Vincent Anderson Regional Hospital, Inc.

Doing business as Ascension St. Vincent Anderson

  • Rehabilitation Hospital Unit
  • Anderson, IN
National Provider Identifier
1376619288
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
060050781 Issued in IN
Legal business name
ST. VINCENT ANDERSON REGIONAL HOSPITAL, INC.
Doing business as
Ascension St. Vincent Anderson
Practice address
2015 Jackson St
Anderson, IN 46016-4337
Phone
(765) 646-8243
Fax
(765) 646-8655
NPI assigned
Nov 24, 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
Becky Jacobson
Title
Vice President of Finance
Phone
(317) 582-7219

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 060050781 IN Primary

Addresses

Primary practice location

2015 Jackson St
Anderson, IN 46016-4337

Mailing address

2015 Jackson St
Anderson, IN 46016-4337
Phone (765) 646-8243

Other names 1

  • Ascension St. Vincent Anderson Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130205000098 IN Part A Provider - Hospital 5890949622 Practice locations: Anderson, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376619288. Details of each certification follow.

Hospital certification: CCN 15T088

Legal name
ST VINCENT ANDERSON REGIONAL HOSPITAL INC
Doing business as
ASCENSION ST VINCENT ANDERSON
Organization structure
CorporationNon-profit
Incorporated
Aug 24, 2012 in IN
Enrollment address
2015 Jackson St
Anderson, IN 46016-4337
Hospital Rehabilitation Unit
Hospital subgroups
Acute care

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

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Bennett Rehabilitation CenterCCN 15T088 · All quality measures
Ownership
Non-profit
Certified
Jun 1, 1989

National Provider Directory

National Provider Directory
Tax ID family
St Vincent Anderson Regional Hospital Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Margaret Johnson Individual Corporate OfficerPresidnet Jul 1, 2021 100%
W-2 Managing EmployeePresident Jul 1, 2021
Georgiana Reynal Individual Corporate DirectorBoard Member Jul 1, 2021
Jonathan S Nalli Individual Corporate OfficerHome Office President & Ceo Feb 1, 2014
Eileen Flavin Individual Corporate DirectorBoard Member Jan 1, 2013
John Pistole Individual Corporate DirectorBoard Member Jul 1, 2019
Aaron G Shoemaker Individual Corporate DirectorBoard Member Jul 1, 2019
Michael Austin Individual Corporate DirectorBoard Member Jan 1, 2013
Brian Edwards Individual Corporate DirectorBoard Member Jul 1, 2019
St Vincent Anderson Regional Hospital Inc Organization, Anderson, IN Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2013 100%
Operational/Managerial Control Jan 1, 2013
Becky Jacobson Individual Corporate OfficerVP of Finance Jul 1, 2019
W-2 Managing EmployeeVP of Finance Jul 1, 2019
Joseph Floyd Barnett Individual Corporate DirectorBoard Member Jul 1, 2019
St Vincent Health Inc Organization, Indianapolis, IN Non-profit Operational/Managerial Control Jan 1, 2013
Mark McDermit Individual Corporate DirectorBoard Member Jul 1, 2019
Bobbette Snyder Individual Corporate DirectorBoard Member Jul 1, 2019

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Ascension St. Vincent AndersonAnderson, IN, CCN 150088 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2013

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 29

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

View all 29

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593388800000",
    "number": "1376619288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 JACKSON ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460164337",
            "telephone_number": "765-646-8243",
            "fax_number": "765-646-8655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 JACKSON ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460164337",
            "telephone_number": "765-646-8243",
            "fax_number": "765-646-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VINCENT ANDERSON REGIONAL HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "317-582-7219"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "IN",
            "license": "060050781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension St. Vincent Anderson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anderson, IN

Sources for this page

Verify at the official NPI Registry.