NPIMap

Organization Active NPI

Marion General Hospital

Doing business as Fairmount Medical Associates

  • Internal Medicine Physician
  • Fairmount, IN
National Provider Identifier
1619020575
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MARION GENERAL HOSPITAL
Doing business as
Fairmount Medical Associates
Practice address
157 W 8TH St
Fairmount, IN 46928-1012
Phone
(765) 660-7880
Fax
(765) 382-4490
NPI assigned
Jan 22, 2007
Last updated
Jun 16, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
MARION GENERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Authorized official

Name
Stephanie Hilton-Siebert
Title
President/Ceo
Phone
(765) 660-7005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

157 W 8TH St
Fairmount, IN 46928-1012

Mailing address

330 N Wabash
Ste G20
Marion, IN 46952-2555
Phone (765) 660-7880

Other identifiers 1

IdentifierTypeStateIssuer
100269250MedicaidIN

Other names 1

  • Fairmount Medical Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040524001483 IN Part B Supplier - Clinic/Group Practice 9133023625 Receives reassigned benefits from 139 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Marion, IN; Swayzee, IN; Gas City, IN; Fairmount, IN; Converse, IN

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Part of
Jeffrey D Breckenridge

Member organizations 1

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

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592265600000",
    "number": "1619020575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N WABASH",
            "address_2": "STE G20",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522555",
            "telephone_number": "765-660-7880",
            "fax_number": "765-382-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 W 8TH ST",
            "city": "FAIRMOUNT",
            "state": "IN",
            "postal_code": "469281012",
            "telephone_number": "765-660-7880",
            "fax_number": "765-382-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARION GENERAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARION GENERAL HOSPITAL",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A",
        "authorized_official_last_name": "HILTON-SIEBERT",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "765-660-7005"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100269250",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairmount Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fairmount Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairmount, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.