NPIMap

Organization Active NPI

Windrose Health Network Inc

Doing business as Windrose Health Network - Avon

  • Federally Qualified Health Center (FQHC)
  • Avon, IN
National Provider Identifier
1447822150
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
WINDROSE HEALTH NETWORK INC
Doing business as
Windrose Health Network - Avon
Practice address
6655 E US Highway 36 Ste 164
Avon, IN 46123-8923
Phone
(888) 714-1927
NPI assigned
Jul 13, 2021
Last updated
Jul 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Authorized official

Name
Scott K Rollett
Title
Ceo
Phone
(317) 739-4895

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

6655 E US Highway 36 Ste 164
Avon, IN 46123-8923

Mailing address

14 Trafalgar SQ
Trafalgar, IN 46181-9515
Phone (317) 739-4895

Other names 1

  • Windrose Health Network - Avon Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041018000851 IN Part B Supplier - Clinic/Group Practice 8426965039 Receives reassigned benefits from 47 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hope, IN; Trafalgar, IN; Indianapolis, IN; Franklin, IN; Avon, IN
O20211102000418 IN Part A Provider - Federally Qualified Health Center (FQHC) 8426965039 Practice locations: Avon, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447822150. Details of each certification follow.

Federally qualified health center certification: CCN 151126

Legal name
WINDROSE HEALTH NETWORK INC
Doing business as
WINDROSE HEALTH NETWORK - AVON
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 2, 2021
Last certification
Nov 2, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 4, 1996 in IN
Enrollment address
6655 E US Highway 36
Ste 164
Avon, IN 46123-8923

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Trafalgar Fam Health Ce8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

163 Butner Dr
Hope, IN 47246
Phone (812) 546-6000

8 N US Highway 31
Whiteland, IN 46184
Phone (317) 530-3111

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Shirley M Robertson Individual Corporate DirectorBoard Member Jan 1, 2013
Linda Adams Individual Corporate DirectorBoard Member Mar 1, 2019
Monica Anderson Individual Corporate DirectorBoard Member Mar 1, 2019
Melissa J Harrier Individual Corporate DirectorBoard Member Jan 1, 2013
Dennis Chasteen Individual Corporate DirectorBoard Member Dec 15, 2014
Michelle Bisesi Individual Corporate DirectorBoard Member Mar 1, 2019
Esmeralda a. Gonzalez Individual Corporate DirectorBoard Member Mar 1, 2019
Scott K Rollett Individual Corporate OfficerCeo Dec 20, 2016
W-2 Managing EmployeeCeo Dec 20, 2016
Operational/Managerial ControlCeo Dec 20, 2016
Van T Piang Individual Corporate DirectorBoard Member Mar 1, 2019
Janet L Buchanan Individual Corporate DirectorBoard Member Dec 20, 2016
Leonard Terri Roberts Individual Corporate DirectorBoard Member Mar 1, 2019
William Mink Individual Corporate DirectorBoard Member Mar 1, 2019
Sharon L Waltz Individual Corporate DirectorBoard Member Dec 20, 2016
Hlalum Thangmatu Individual Corporate DirectorBoard Member Mar 1, 2019
Nicole Spears Individual Corporate DirectorBoard Member Mar 1, 2019
Atin Tandon Individual Corporate DirectorBoard Member Mar 1, 2019
Thomas Weartz Individual Corporate DirectorBoard Member Dec 20, 2016
Robert P Young Individual Corporate DirectorBoard Member Mar 1, 2019

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 2

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

FacilityTypeRoleSince
Windrose Health Network -CountylineIndianapolis, IN, CCN 151876 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Nov 1, 2011
Nov 1, 2011
Windrose Health Network-EdinburghEdinburgh, IN, CCN 151041 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2017

Owned or controlled facilities with NPI records 2

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

  • Windrose Health Network, Inc.

    dba Windrose Health Network - Countyline

    • Federally Qualified Health Center (FQHC)
    • Indianapolis, IN
    • NPI 1154699346

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Windrose Health Network, Inc.

    dba Windrose Health Network-Edinburgh

    • Federally Qualified Health Center (FQHC)
    • Edinburgh, IN
    • NPI 1295207827

    5% Or Greater Direct Ownership Interest

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 41

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.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626134400000",
    "number": "1447822150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 TRAFALGAR SQ",
            "city": "TRAFALGAR",
            "state": "IN",
            "postal_code": "461819515",
            "telephone_number": "317-739-4895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6655 E US HIGHWAY 36 STE 164",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461238923",
            "telephone_number": "888-714-1927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDROSE HEALTH NETWORK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-13",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A",
        "authorized_official_last_name": "ROLLETT",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-739-4895"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Windrose Health Network - Avon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Avon, IN

Sources for this page

Verify at the official NPI Registry.