Grant County Auditor

Organization Active NPI Community Health Registered Nurse · Marion, IN

NPI 1821148263 · NPPES record last updated Feb 23, 2022

Key facts

NPI
1821148263
Entity type
Organization (NPI type 2)
Primary specialty
Community Health Registered Nurse 163WC1500X
Legal business name
GRANT COUNTY AUDITOR
Practice address
401 S Adams St
Nursing Division
Marion, IN 46953-2037
Phone
(765) 662-0377
Fax
(765) 662-9028
NPI assigned
Jan 10, 2007
Organization subpart
No

Authorized official

Name
Dr. William David Moore, M. D.
Title
Grant County Health Officer
Phone
(765) 662-0377

Other NPIs with the same Medicare PAC ID 1

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

Corporate family (same tax ID) 2

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

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0709878Grant County Health Department
401 S Adams St, Marion, IN 46953
Certificate of waiverJun 22, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20070918000602 IN Part B Supplier - Mass Immunization (Roster Biller Only) 8628162138 Practice locations: Marion, IN

National Provider Directory

Tax ID family
Grant County Auditor (3 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse
Group: 193400000X SINGLE SPECIALTY GROUP
163WC1500X Yes

Addresses

Primary practice location

401 S Adams St
Nursing Division
Marion, IN 46953-2037

Mailing address

401 S Adams St
Nursing Division
Marion, IN 46953-2037
Phone (765) 662-0377

Other identifiers

IdentifierTypeStateIssuer
TA0060OtherINMEDICARE PART B
TA0060OtherMEDICARE PTAN #

Other names

  • Grant County Health Department Doing business as
  • Grant County Health Dept/Nursing Division Doing business as

Other providers in Marion, IN

All providers in Marion, IN · Community Health Registered Nurse in Indiana

Sources for this page

Verify at the official NPI Registry.