Sullivan County Community Hospital

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

05-003248-1 Issued in IN

Legal business name

SULLIVAN COUNTY COMMUNITY HOSPITAL

Practice address

2110 N Hospital Blvd Ste 3
Sullivan, IN 47882-7656

Phone

(812) 268-4311

Fax

(812) 268-2654

NPI assigned

May 24, 2005

Organization subpart

Yes

Parent organization

SULLIVAN COUNTY COMMUNITY HOSPITALAs reported in NPPES

Name

Ms. Kenisha J. Simmons, RN

Title

Director

Phone

(812) 268-4311

Part of

Sullivan County Community Hospital

Locations

• Sullivan County Community Hospital Home Health Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 15, 2014.

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405382400000",
    "number": "1790788537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "address_2": "2110 N. HOSPITAL BLVD, SUITE #3",
            "city": "SULLIVAN",
            "state": "IN",
            "postal_code": "478820010",
            "telephone_number": "812-268-4311",
            "fax_number": "812-268-2654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 N HOSPITAL BLVD STE 3",
            "city": "SULLIVAN",
            "state": "IN",
            "postal_code": "478827656",
            "telephone_number": "812-268-4311",
            "fax_number": "812-268-2654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULLIVAN COUNTY COMMUNITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SULLIVAN COUNTY COMMUNITY HOSPITAL",
        "enumeration_date": "2005-05-24",
        "last_updated": "2014-07-15",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "KENISHA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "812-268-4311",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IN",
            "license": "05-003248-1",
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200387670A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sullivan County Community Hospital Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sullivan County Community Hospital
• Sullivan County Community Hospital
• Sullivan County Community Hospital
• Sullivan County Community Hospital
• Sullivan County Community Hospital
• Sullivan Family Dentistry, LLC
• Sullivan Family Eye Care P C
• Sullivan Family Practice, LLC
• Sullivan Health & Living Center, Inc.
• Sullivan Rehabilitation & Sports Physical Therapy, Inc.

• All providers in Sullivan, IN
• Home Health Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; 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.