NPIMap

Organization Active NPI

Jay County Hospital

  • Emergency Medicine Physician
  • Portland, IN
National Provider Identifier
1467601757
Registry record updated May 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
JAY COUNTY HOSPITAL
Practice address
500 W Votaw St
Portland, IN 47371-1322
Phone
(260) 726-7131
Fax
(260) 726-1975
NPI assigned
Sep 11, 2008
Last updated
May 2, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2017

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

Authorized official

Name
Don Michael
Title
Cfo
Phone
(260) 726-1818

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X
Emergency Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

500 W Votaw St
Portland, IN 47371-1322

Mailing address

500 W Votaw St
Portland, IN 47371-1322
Phone (260) 726-7131

Other identifiers 1

IdentifierTypeStateIssuer
100269620MedicaidIN

National Provider Directory

National Provider Directory

Locations

428 W Votaw St
#B
Portland, IN 47371

428A W Votaw St
Ste A
Portland, IN 47371

500 W Votaw St
Ste A
Portland, IN 47371
Phone (260) 726-2313

Practitioners & affiliated clinicians

Practitioners 9

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": "1221091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493683200000",
    "number": "1467601757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W VOTAW ST",
            "city": "PORTLAND",
            "state": "IN",
            "postal_code": "473711322",
            "telephone_number": "260-726-7131",
            "fax_number": "260-726-1975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W VOTAW ST",
            "city": "PORTLAND",
            "state": "IN",
            "postal_code": "473711322",
            "telephone_number": "260-726-7131",
            "fax_number": "260-726-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAY COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-11",
        "last_updated": "2017-05-02",
        "status": "A",
        "authorized_official_last_name": "MICHAEL",
        "authorized_official_first_name": "DON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "260-726-1818"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100269620",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2017; 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.