NPIMap

Organization Active NPI

Community Health Network Rehabilitation Hospital South, LLC

Doing business as Community Health Network Rehabilitation Hospital South

  • Rehabilitation Hospital
  • Greenwood, IN
National Provider Identifier
1790285500
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
Legal business name
COMMUNITY HEALTH NETWORK REHABILITATION HOSPITAL SOUTH, LLC
Doing business as
Community Health Network Rehabilitation Hospital South
Practice address
607 Greenwood Springs Dr
Greenwood, IN 46143-6377
Phone
(317) 215-3800
NPI assigned
Feb 19, 2018
Last updated
Aug 28, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2019

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

Authorized official

Name
Michelle Russell
Title
Hospital Ceo
Phone
(317) 215-3800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X Primary

Addresses

Primary practice location

607 Greenwood Springs Dr
Greenwood, IN 46143-6377

Mailing address

607 Greenwood Springs Dr
Greenwood, IN 46143-6377
Phone (317) 215-3800

Other names 1

  • Community Health Network Rehabilitation Hospital South Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180516000315 IN Part A Provider - Hospital 1951665462 Practice locations: Greenwood, IN

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1790285500. Details of each certification follow.

Hospital certification: CCN 153044

Legal name
COMMUNITY HEALTH NETWORK REHABILITATION HOSPITAL SOUTH LLC
Doing business as
COMMUNITY HEALTH NETWORK REHABILITATION HOSPITAL SOUTH
Certification status
Active
Provider type (POS)
Hospital – Rehabilitation
Participating since
Sep 18, 2018
Last certification
Sep 18, 2018
Beds
44
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
May 2, 2017 in DE
Enrollment address
607 Greenwood Springs Dr
Greenwood, IN 46143-6377
Other Hospital Practice Location
Hospital subgroups
Rehabilitation unit

Hospital certification: CCN 152008

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
KINDRED HOSPITAL- INDIANAPOLIS SOUTH
Certification status
Terminated Voluntary: merger or closure, Sep 21, 2017
Provider type (POS)
Hospital – Long-term
Participating since
Jun 1, 1994
Last certification
Apr 20, 2005
Beds
60
Ownership / control type
Private (for profit)
Facility address
607 Greenwood Springs Drive
Greenwood, IN 46143

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Community Health Network Rehabilitation Hosp SoCCN 153044 · All quality measures
Ownership
For profit
Certified
Sep 18, 2018
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2150574Community Health Network Rehabilitation Hospital607 Greenwood Springs Drive, Greenwood, IN 46143Certificate of waiverJun 26, 2028

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

607 Greenwood Springs Dr
Greenwood, IN 46143
Phone (317) 215-3800

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Jason R Fahrlander Individual Corporate DirectorBoard Member Sep 18, 2017
Lifepoint Rehab Blocker LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest Dec 31, 2022 49%
Community Health Network Inc Organization, Indianapolis, IN Corporation 5% Or Greater Direct Ownership Interest Jun 22, 2017 51%
CHC Management Services LLC Organization, Brentwood, TN LLC, Management services company, For-profit Operational/Managerial Control Jun 22, 2017
Lifepoint Rehab LLC Organization, Brentwood, TN LLC 5% Or Greater Indirect Ownership Interest Dec 23, 2021 49%
James E Ransom Individual Corporate DirectorBoard Member May 1, 2020
DSB Acquisition LLC Organization, New York, NY LLC 5% Or Greater Indirect Ownership Interest Dec 23, 2021 49%
KND Development 63, LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Direct Ownership Interest Jun 22, 2017 49%
Lifepoint Health Inc Organization, Brentwood, TN Corporation 5% Or Greater Indirect Ownership Interest Dec 23, 2021 49%
Marcus B Poppell Individual OtherVice President Dec 23, 2021
David I Stark Individual Corporate DirectorBoard Member Sep 18, 2017
Lori Cole Individual Corporate DirectorBoard of Manager Apr 12, 2023
Holly Millard Individual Corporate DirectorBoard Member Dec 12, 2018
Michelle Russell Individual Corporate OfficerHospital Ceo Jul 15, 2019
Operational/Managerial ControlHospital Ceo Jul 15, 2019
Anita Capps Individual Corporate Director Apr 12, 2023
Lifepoint Rehab Blocker Parent LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest Dec 31, 2022 49%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 74

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 74

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566950400000",
    "number": "1790285500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 GREENWOOD SPRINGS DR",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461436377",
            "telephone_number": "317-215-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 GREENWOOD SPRINGS DR",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461436377",
            "telephone_number": "317-215-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH NETWORK REHABILITATION HOSPITAL SOUTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-19",
        "last_updated": "2019-08-28",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "HOSPITAL CEO",
        "authorized_official_telephone_number": "317-215-3800"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Health Network Rehabilitation Hospital South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenwood, IN

Sources for this page

Verify at the official NPI Registry.