NPIMap

Organization Active NPI

St. Mary'S Warrick Hospital, Inc.

  • Diagnostic Radiology Physician
  • Boonville, IN
National Provider Identifier
1508026402
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
ST. MARY'S WARRICK HOSPITAL, INC.
Practice address
1116 Millis Ave
Boonville, IN 47601-2226
Phone
(812) 897-4800
Fax
(812) 897-7375
NPI assigned
Jun 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Authorized official

Name
Daniel Parod
Title
Ceo
Phone
(812) 485-1502

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X 07-005111-1 IN
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary
Critical Access Hospital 282NC0060X 07-005111-1 IN

Addresses

Primary practice location

1116 Millis Ave
Boonville, IN 47601-2226

Mailing address

1116 Millis Ave
Boonville, IN 47601-2204
Phone (812) 897-4800

Other identifiers 5

IdentifierTypeStateIssuer
000000054351OtherINBLUE CROSS BLUE SHIELD
032184200OtherINFEDERAL BLACK LUNG
1341114MedicaidKY
200043160MedicaidIN
I013944OtherINCHAMPUS

Other names 2

  • Ascension St. Vincent Warrick Doing business as
  • ER Physicians Group Other name

National Provider Directory

National Provider Directory

Locations

1116 Millis Ave
Boonville, IN 47601
Phone (812) 897-4800

NPI Registry JSON

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

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604966400000",
    "number": "1508026402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 MILLIS AVE",
            "city": "BOONVILLE",
            "state": "IN",
            "postal_code": "476012204",
            "telephone_number": "812-897-4800",
            "fax_number": "812-897-7375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 MILLIS AVE",
            "city": "BOONVILLE",
            "state": "IN",
            "postal_code": "476012226",
            "telephone_number": "812-897-4800",
            "fax_number": "812-897-7375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY'S WARRICK HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-13",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A",
        "authorized_official_last_name": "PAROD",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-485-1502"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "07-005111-1",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "IN",
            "license": "07-005111-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000054351",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "032184200",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1341114",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200043160",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "I013944",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension St. Vincent Warrick",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ER Physicians Group",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "ER Physicians Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Boonville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.