NPIMap

Organization Active NPI

Switzerland County Auditor'S Office

  • Rural Health Clinic/Center
  • Vevay, IN
National Provider Identifier
1699778902
Registry record updated Jun 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SWITZERLAND COUNTY AUDITOR'S OFFICE
Practice address
1190 W Main St
Ste 300
Vevay, IN 47043-3639
Phone
(812) 427-4038
Fax
(812) 427-3246
NPI assigned
May 31, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2010

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

Authorized official

Name
Mr. Greg Andrew Fillenwarth, APRN,BC
Title
Nurse Practitioner
Phone
(812) 427-4038

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1190 W Main St
Ste 300
Vevay, IN 47043-3639

Mailing address

1190 W Main St
Ste 300
Vevay, IN 47043-3639
Phone (812) 427-4038

Other identifiers 1

IdentifierTypeStateIssuer
200254390AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040908000277 IN Part A Provider - Rural Health Clinic 0244122174 Practice locations: Vevay, IN
O20131002000073 IN Part B Supplier - Clinic/Group Practice 0244122174 Receives reassigned benefits from 1 practitioner
Practice locations: Vevay, IN

Rural health clinic certification: CCN 153862

Legal name
SWITZERLAND COUNTY AUDITORS OFFICE
Doing business as
SWITZERLAND COUNTY NURSE MANAGED CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 15, 2000
Last certification
Sep 22, 2020
Ownership / control type
2A
Organization structure
GovernmentNon-profit
Enrollment address
1190 W Main Street
Suite 300
Vevay, IN 47043-3639

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Switzerland County Health Department3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Switzerland County Auditors Office Organization, Vevay, IN 5% Or Greater Direct Ownership Interest Dec 17, 2007
Operational/Managerial Control Dec 17, 2007
Scott M Frede Individual Corporate DirectorMedical Director Nov 19, 2001 100%
Katia Vassileva Stefanova Individual W-2 Managing EmployeeAprn Jul 8, 2013
Operational/Managerial Control Jul 8, 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 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276214400000",
    "number": "1699778902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 W MAIN ST",
            "address_2": "STE 300",
            "city": "VEVAY",
            "state": "IN",
            "postal_code": "470433639",
            "telephone_number": "812-427-4038",
            "fax_number": "812-427-3246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 W MAIN ST",
            "address_2": "STE 300",
            "city": "VEVAY",
            "state": "IN",
            "postal_code": "470433639",
            "telephone_number": "812-427-4038",
            "fax_number": "812-427-3246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWITZERLAND COUNTY AUDITOR'S OFFICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2010-06-11",
        "status": "A",
        "authorized_official_last_name": "FILLENWARTH",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "812-427-4038",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "APRN,BC"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200254390A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vevay, IN

Sources for this page

Verify at the official NPI Registry.