NPIMap

Organization Active NPI

State of Indiana, Auditor of State

Doing business as Madison State Hospital

  • Psychiatric Hospital
  • Madison, IN
National Provider Identifier
1659497477
Registry record updated Dec 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
STATE OF INDIANA, AUDITOR OF STATE
Doing business as
Madison State Hospital
Practice address
711 Green Rd
Madison, IN 47250-2143
Phone
(812) 265-2611
Fax
(812) 265-7227
NPI assigned
Mar 22, 2007
Last updated
Dec 17, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2007

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

Authorized official

Name
Dr. Peggy S Stephens, MDNPI 1699765115
Title
Superintendant and Medical Director
Phone
(812) 265-2611

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X NU Primary

Addresses

Primary practice location

711 Green Rd
Madison, IN 47250-2143

Mailing address

711 Green Rd
Madison, IN 47250-2143
Phone (812) 265-2611

Other identifiers 2

IdentifierTypeStateIssuer
PROFESSIONAL COMPOtherINGROUP
941750OtherMEDICARE B

Other names 1

  • MADISON STATE HOSPITAL Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040105000564 IN Part B Supplier - Clinic/Group Practice 1759280118 Receives reassigned benefits from 113 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Evansville, IN; Indianapolis, IN; Logansport, IN; Madison, IN; Richmond, IN; West Lafayette, IN

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
State Board of Health32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197849600000",
    "number": "1659497477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 GREEN RD",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472502143",
            "telephone_number": "812-265-2611",
            "fax_number": "812-265-7227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 GREEN RD",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472502143",
            "telephone_number": "812-265-2611",
            "fax_number": "812-265-7227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF INDIANA, AUDITOR OF STATE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-12-17",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SUPERINTENDANT AND MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "812-265-2611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP",
            "identifier": "PROFESSIONAL COMP",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE B",
            "identifier": "941750",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MADISON STATE HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; 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.