NPIMap

Organization Active NPI

Franciscan Health Rensselaer, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Rensselaer, IN
National Provider Identifier
1669558300
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
05-005072-2 Issued in IN
Legal business name
FRANCISCAN HEALTH RENSSELAER, INC.
Practice address
1104 E Grace St
Rensselaer, IN 47978-3211
Phone
(219) 866-5141
Fax
(219) 866-3234
NPI assigned
Oct 27, 2006
Last updated
Oct 17, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
FRANCISCAN HEALTH RENSSELAERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Authorized official

Name
Mr. Terrance E Wilson
Title
President & Chief Executive Officer
Phone
(765) 502-4440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 05-005072-2 IN Primary

Addresses

Primary practice location

1104 E Grace St
Rensselaer, IN 47978-3211

Mailing address

1104 E Grace St
Rensselaer, IN 47978-3211
Phone (219) 866-5141

Other identifiers 8

IdentifierTypeStateIssuer
0564195MedicaidIN
100269660AMedicaidIN
80536700MedicaidWI
0175224MedicaidOH
MEDICAID CARESOURCEMedicaidIN
000000097884OtherINBLUE CROSS ID
0150078MedicaidTN
909962000MedicaidFL

National Provider Directory

National Provider Directory
Part of
Jasper County Hospital

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476662400000",
    "number": "1669558300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 E GRACE ST",
            "city": "RENSSELAER",
            "state": "IN",
            "postal_code": "479783211",
            "telephone_number": "219-866-5141",
            "fax_number": "219-866-3234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 E GRACE ST",
            "city": "RENSSELAER",
            "state": "IN",
            "postal_code": "479783211",
            "telephone_number": "219-866-5141",
            "fax_number": "219-866-3234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANCISCAN HEALTH RENSSELAER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANCISCAN HEALTH RENSSELAER",
        "enumeration_date": "2006-10-27",
        "last_updated": "2016-10-17",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "765-502-4440",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "IN",
            "license": "05-005072-2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0564195",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100269660A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80536700",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0175224",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MEDICAID CARESOURCE",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS ID",
            "identifier": "000000097884",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0150078",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "909962000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rensselaer, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.