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Organization Active NPI

Fayette Memorial Hospital Association Inc

Doing business as Fayette Regional Health System

  • Rehabilitation Hospital Unit
  • Connersville, IN
National Provider Identifier
1508835216
Registry record updated May 27, 2015
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Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
050050591 Issued in IN
Legal business name
FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC
Doing business as
Fayette Regional Health System
Practice address
1941 Virginia Ave
Connersville, IN 47331-2833
Phone
(765) 827-7900
Fax
(765) 827-7907
NPI assigned
Mar 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2015

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

Authorized official

Name
Randall White
Title
Ceo
Phone
(765) 827-7987

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 050050591 IN Primary

Addresses

Primary practice location

1941 Virginia Ave
Connersville, IN 47331-2833

Mailing address

1941 Virginia Ave
Connersville, IN 47331-2833
Phone (765) 827-8933

Other identifiers 1

IdentifierTypeStateIssuer
100268210AMedicaidIN

Other names 1

  • Fayette Regional Health System Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Hospital certification: CCN 150064

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
FAYETTE REGIONAL HEALTH SYSTEM
Certification status
Terminated Voluntary: merger or closure, Jul 16, 2019
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jun 25, 2009
Beds
105
Ownership / control type
Private (for profit)
Facility address
1941 Virginia Ave
Connersville, IN 47331

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432684800000",
    "number": "1508835216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 VIRGINIA AVE",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473312833",
            "telephone_number": "765-827-8933",
            "fax_number": "765-827-7863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 VIRGINIA AVE",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473312833",
            "telephone_number": "765-827-7900",
            "fax_number": "765-827-7907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2015-05-27",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "765-827-7987"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "IN",
            "license": "050050591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100268210A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fayette Regional Health System",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Connersville, IN

Sources for this page

Verify at the official NPI Registry.