NPIMap

Organization Active NPI

Indiana Masonic Home, Inc.

  • Home Health Agency
  • Franklin, IN
National Provider Identifier
1578093605
Registry record updated Nov 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
17-013621-1 Issued in IN
Legal business name
INDIANA MASONIC HOME, INC.
Practice address
690 S State St
Franklin, IN 46131-2553
Phone
(317) 739-0772
NPI assigned
Jun 12, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2017

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

Authorized official

Name
Jeffrey K. Saunders
Title
President
Phone
(317) 431-6170

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 17-013621-1 IN Primary

Addresses

Primary practice location

690 S State St
Franklin, IN 46131-2553

Mailing address

690 S State St
Franklin, IN 46131-2553
Phone (317) 739-0772

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171024002618 IN Part A Provider - Home Health Agency 1759378516 Practice locations: Franklin, IN

Home health agency certification: CCN 157700

Legal name
INDIANA MASONIC HOME, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 26, 2018
Last certification
Jun 26, 2018
Ownership / control type
Proprietary
Organization structure
CorporationNon-profit
Incorporated
Nov 15, 2002 in IN
Enrollment address
690 S State St
Franklin, IN 46131-2553

Care Compare: Home health agency

Medicare Care Compare
Listed as
Indiana Masonic Home, IncCCN 157700
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Jun 26, 2018
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Indiana Masonic Home Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member organizations 2

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

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
Michael Dempset Individual Corporate DirectorBoard Member May 31, 2017
Charles Michael Spencer Individual Corporate OfficerExe Dir May 31, 2017
Corporate DirectorExe Dir May 31, 2017
Gary Brinley Individual Corporate DirectorBoard Member May 31, 2017
Ronald Buskirk Individual Corporate DirectorBoard Member May 31, 2017
Indiana Masonic Home, Inc. Organization, Franklin, IN Corporation, Non-profit 5% Or Greater Direct Ownership Interest May 31, 2017 100%
Amy L Barker Individual W-2 Managing EmployeeAdmin May 31, 2017
Alfred Brothers Individual Corporate DirectorBoard Member May 31, 2017
Jerald Miller Individual Corporate DirectorBoard Member May 31, 2017
Christopher Thomas Individual Corporate DirectorBoard Member May 31, 2017
William Reiners Individual Corporate DirectorBoard Member May 31, 2017
Loretta E Riehl Individual Corporate DirectorBoard Member May 31, 2017
Randall Hammond Individual Corporate DirectorBoard Member May 31, 2017
Carey Carter Individual Corporate DirectorBoard Member May 31, 2017
Jeffrey Sanders Individual Corporate DirectorPres May 31, 2017
Rodney a Mann Individual Corporate DirectorBoard Member May 31, 2017
Kenneth E Willis Individual Corporate DirectorBoard Member May 31, 2017
Richard J Elman Individual Corporate DirectorBoard Member May 31, 2017
Denny Sheets Individual Corporate DirectorBoard Member May 31, 2017
Richard Lentz Individual Corporate DirectorBoard Member May 31, 2017
Jeffery P Zaring Individual Corporate DirectorBoard Member May 31, 2017

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Compass ParkFranklin, IN, CCN 155593 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2025
Jan 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 8

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

NPI Registry JSON

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

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510617600000",
    "number": "1578093605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 S STATE ST",
            "city": "FRANKLIN",
            "state": "IN",
            "postal_code": "461312553",
            "telephone_number": "317-739-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 S STATE ST",
            "city": "FRANKLIN",
            "state": "IN",
            "postal_code": "461312553",
            "telephone_number": "317-739-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA MASONIC HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-12",
        "last_updated": "2017-11-14",
        "status": "A",
        "authorized_official_last_name": "SAUNDERS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-431-6170"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IN",
            "license": "17-013621-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, IN

Sources for this page

Verify at the official NPI Registry.