NPIMap

Organization Active NPI

St. Vincent Madison County Health System, Inc

Doing business as St. Vincent Mercy Hospital

  • Critical Access Hospital
  • Elwood, IN
National Provider Identifier
1477508596
Registry record updated May 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
060050832 Issued in IN
Legal business name
ST. VINCENT MADISON COUNTY HEALTH SYSTEM, INC
Doing business as
St. Vincent Mercy Hospital
Practice address
1331 S a St
Elwood, IN 46036-1942
Phone
(765) 552-4600
Fax
(765) 552-4775
NPI assigned
May 24, 2006
Last updated
May 19, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2014

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

Authorized official

Name
Ann Yates
Title
Director of Nursing, St. Vincent Me
Phone
(765) 552-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 060050832 IN Primary

Addresses

Primary practice location

1331 S a St
Elwood, IN 46036-1942

Mailing address

1331 S a St
Elwood, IN 46036-1942
Phone (765) 552-4600

Other names 1

  • St. Vincent Mercy Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131216000577 IN Part A Provider - Critical Access Hospital 2961493614 Practice locations: Elwood, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477508596. Details of each certification follow.

Hospital certification: CCN 151308

Legal name
ST. VINCENT MADISON COUNTY HEALTH SYSTEM, INC.
Doing business as
ASCENSION ST. VINCENT MERCY
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jul 2, 2001
Last certification
Jul 10, 2014
Beds
25
Ownership / control type
Church
Organization structure
CorporationNon-profit
Incorporated
Nov 30, 1955 in IN
Enrollment address
1331 S a St
Elwood, IN 46036-1942
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Ascension St Vincent MercyCCN 151308 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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
15D0352313Ascension St Vincent Mercy Hospital1331 South a Street, Elwood, IN 46036AccreditationAug 16, 2027
15D2078199Amin FRZN Section Lab at St Vincent Mercy Hosp1331 South a St, Elwood, IN 46036AccreditationDec 22, 2027

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

2350 Reliable Pkwy
Chicago, IL 60686

1448 S A St
Elwood, IN 46036
Phone (765) 552-4611

226 S Anderson St
#A
Elwood, IN 46036
Phone (765) 552-3000

101 S Main St
Fairmount, IN 46928

105 S Main St
Fairmount, IN 46928

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
Jacob Steve Baker Individual Corporate DirectorBoard Member Jul 1, 2023
Kevin P Speer Individual Corporate OfficerHome Office - President & Ceo May 1, 2023
Cynthia Dawn Adams Individual Corporate DirectorBoard Member Jul 1, 2018
Carlyle Floyd Individual Corporate DirectorBoard Member Jul 1, 2023
Floyd Grubb Individual Corporate DirectorBoard Member Jul 1, 2023
Michael Todd Emmons Individual Corporate DirectorBoard Member Jul 1, 2023
Dana M Muntz Individual Corporate OfficerVP of Rural Healthcare Jul 1, 2023
Corporate DirectorBoard Member Jul 1, 2023
W-2 Managing EmployeeVP of Rural Healthcare Jul 1, 2023
Ann Yates Individual Corporate OfficerAdministrator Jul 1, 2023
W-2 Managing Employee Jul 1, 2023
Brian Edwards Individual Corporate DirectorBoard Member Jul 1, 2018
Ascension Health Organization, Saint Louis, MO Non-profit Operational/Managerial Control Oct 17, 2003
St Vincent Health Inc Organization, Indianapolis, IN Corporation 5% Or Greater Direct Ownership Interest Nov 23, 2010 100%
Ryan Penrod Individual Corporate DirectorBoard Member Jul 1, 2023

Owners & managing parties with NPI records 1

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

Facilities with the same owner 166

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

View all 166

Practitioners & affiliated clinicians

Affiliated clinicians 44

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

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400457600000",
    "number": "1477508596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 S A ST",
            "city": "ELWOOD",
            "state": "IN",
            "postal_code": "460361942",
            "telephone_number": "765-552-4600",
            "fax_number": "765-552-4775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 S A ST",
            "city": "ELWOOD",
            "state": "IN",
            "postal_code": "460361942",
            "telephone_number": "765-552-4600",
            "fax_number": "765-552-4775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VINCENT MADISON COUNTY HEALTH SYSTEM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2014-05-19",
        "status": "A",
        "authorized_official_last_name": "YATES",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR OF NURSING, ST. VINCENT ME",
        "authorized_official_telephone_number": "765-552-4600"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "IN",
            "license": "060050832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Vincent Mercy Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elwood, IN

Sources for this page

Verify at the official NPI Registry.