NPIMap

Organization Active NPI

Centerstone Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Bloomington, IN
National Provider Identifier
1497305791
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CENTERSTONE HEALTH SERVICES, INC
Doing business as
Centerstone Health Services, Inc.
Practice address
645 S Rogers St Ste a
Bloomington, IN 47403-2353
Phone
(812) 269-5092
NPI assigned
Sep 18, 2019
Last updated
Jul 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Authorized official

Name
Jenny Harrison
Title
Ceo
Phone
(812) 350-8249

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Counselor 101Y00000X NU

Addresses

Primary practice location

645 S Rogers St Ste a
Bloomington, IN 47403-2353

Mailing address

PO Box 623
Indianapolis, IN 46206-0623

Other names 1

  • Centerstone Health Services, Inc. Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070504000012 IN Part B Supplier - Clinic/Group Practice 1850497173 Receives reassigned benefits from 35 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bloomington, IN; Columbus, IN; Connersville, IN; Richmond, IN
O20201230002268 IN Part A Provider - Federally Qualified Health Center (FQHC) 1850497173 Practice locations: Bloomington, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497305791. Details of each certification follow.

Federally qualified health center certification: CCN 151093

Legal name
CENTERSTONE HEALTH SERVICES INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 30, 2020
Last certification
Dec 30, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
645 S Rogers St
Ste a
Bloomington, IN 47403-2353

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 4

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

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
15D2172944Centerstone Health Services, Inc645 S Rogers Street, Bloomington, IN 47403Certificate of waiverOct 1, 2027

National Provider Directory

National Provider Directory
Tax ID family
Centerstone Health Services Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

645 S Rogers St
Bloomington, IN 47403
Phone (812) 339-1691

645 S Rogers St
Ste A
Bloomington, IN 47403
Phone (812) 269-5092

720 N Marr Rd
Ste A
Columbus, IN 47201
Phone (812) 314-3400

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Jennifer Harrison Individual Corporate OfficerCeo Jan 1, 2023 100%
W-2 Managing EmployeeCeo Jan 1, 2023 100%
Operational/Managerial ControlCeo Jan 1, 2023

Practitioners & affiliated clinicians

Practitioners 36

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 36

NPI Registry JSON

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

{
    "created_epoch": "1568764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785283200000",
    "number": "1497305791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 623",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462060623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 S ROGERS ST STE A",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032353",
            "telephone_number": "812-269-5092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERSTONE HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-18",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-350-8249"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centerstone Health Services, Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Centerstone Health Services, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.