NPIMap

Organization Active NPI

St. Clare Medical Center

  • Skilled Nursing Facility
  • Crawfordsville, IN
National Provider Identifier
1508960535
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
ST. CLARE MEDICAL CENTER
Practice address
1710 Lafayette Rd
Crawfordsville, IN 47933-1033
Phone
(765) 362-2800
NPI assigned
Sep 11, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jeffrey C Zeh
Title
Executive Director
Phone
(765) 362-3100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X IN Primary

Addresses

Primary practice location

1710 Lafayette Rd
Crawfordsville, IN 47933-1033

Mailing address

1710 Lafayette Rd
Crawfordsville, IN 47933-1033
Phone (765) 362-2800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060119000049 IN Part A Provider - Hospital 0840276796 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Crawfordsville, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508960535. Details of each certification follow.

Hospital certification: CCN 150022

Legal name
FRANCISCAN HEALTH CRAWFORDSVILLE
Doing business as
FRANCISCAN HEALTH CRAWFORDSVILLE
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
May 6, 2004
Beds
103
Ownership / control type
Church
Organization structure
CorporationNon-profit
Enrollment address
1710 Lafayette Rd
Crawfordsville, IN 47933-1033
Main/Primary Hospital Location
Hospital subgroups
Acute care

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Franciscan Health CrawfordsvilleCCN 150022 · All quality measures
Overall star rating
5 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

402 W Market St
Crawfordsville, IN 47933
Phone (765) 362-6740

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Ann K Magiera Individual Corporate Director Jan 1, 2007
Madonna Rougeau Individual Corporate Director Jan 1, 2007
Kenneth Herlin Individual Corporate Director Jan 1, 2014
Marilyn Oliver Individual Corporate Director Jan 1, 2007
Kevin D Leahy Individual Corporate Director Jan 1, 2007
Anna F. Hoefer Individual Corporate Director Aug 15, 2023
Kathleen Goeppinger Individual Corporate Director Jan 1, 2007
Franciscan Alliance Inc Organization, Mishawaka, IN Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2007 100%
Margaret Mary Mitchel Individual Corporate Director Aug 15, 2023
Ernest Iannotta Individual Corporate Director Jan 1, 2012
Lethia M Leveille Individual Corporate Director Jan 1, 2013
Pamela J Shultz Individual Corporate Officer Aug 15, 2023
Marie Morgan Individual Corporate Director Aug 15, 2023
Catherine C Nielsen Individual Corporate DirectorDirector Oct 6, 2014
Terrence Klein Individual W-2 Managing Employee Oct 1, 2013
Terrance E Wilson Individual Corporate Officer Jul 1, 2013
Alan Gillespie Individual Corporate Director Dec 27, 2021
Hilton Hudson Individual Corporate Director Dec 27, 2021
Marlene Shapley Individual Corporate Director Jan 1, 2007
Jason Geddes Individual W-2 Managing Employee Jun 1, 2013

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 3

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.

Affiliated clinicians 227

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

View all 227

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508960535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 LAFAYETTE RD",
            "city": "CRAWFORDSVILLE",
            "state": "IN",
            "postal_code": "479331033",
            "telephone_number": "765-362-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 LAFAYETTE RD",
            "city": "CRAWFORDSVILLE",
            "state": "IN",
            "postal_code": "479331033",
            "telephone_number": "765-362-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CLARE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZEH",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "765-362-3100"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crawfordsville, IN

Sources for this page

Verify at the official NPI Registry.