Active NPI
Hickory Creek Healthcare Foundation, Inc.
- Skilled Nursing Facility
- Lebanon, IN
National Provider Identifier
1740214493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- HICKORY CREEK HEALTHCARE FOUNDATION, INC.
- Doing business as
- Hickory Creek at Lebanon
- Practice address
- 1585 Perry Worth Rd
Lebanon, IN 46052-9635 - Phone
- (765) 482-6391
- Fax
- (765) 483-2590
- NPI assigned
- Jul 10, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Gary Brent Waymire
- Title
- Vice President of Operations
- Phone
- (317) 570-0266
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | IN | Primary |
Addresses
Primary practice location
1585 Perry Worth Rd
Lebanon, IN 46052-9635
Mailing address
1585 Perry Worth Rd
Lebanon, IN 46052-9635
Phone (765) 482-6391
Other names 1
- Hickory Creek at Lebanon
National Provider Directory
National Provider Directory- Tax ID family
- Hickory Creek Healthcare Foundation Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Intellectual Disabilities Intermediate Care Facility
- Gaston, IN
- NPI 1265463665
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Intellectual Disabilities Intermediate Care Facility
- Gaston, IN
- NPI 1265463665
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1740214493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1585 PERRY WORTH RD",
"city": "LEBANON",
"state": "IN",
"postal_code": "460529635",
"telephone_number": "765-482-6391",
"fax_number": "765-483-2590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1585 PERRY WORTH RD",
"city": "LEBANON",
"state": "IN",
"postal_code": "460529635",
"telephone_number": "765-482-6391",
"fax_number": "765-483-2590"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HICKORY CREEK HEALTHCARE FOUNDATION, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-10",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "WAYMIRE",
"authorized_official_first_name": "GARY",
"authorized_official_middle_name": "BRENT",
"authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
"authorized_official_telephone_number": "317-570-0266",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "IN",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Hickory Creek at Lebanon",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lebanon, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.