NPIMap

Organization Active NPI

Southern Indiana Community Health Care, Inc

Doing business as Valley Health

  • Federally Qualified Health Center (FQHC)
  • West Baden Springs, IN
National Provider Identifier
1841706868
Registry record updated Feb 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SOUTHERN INDIANA COMMUNITY HEALTH CARE, INC
Doing business as
Valley Health
Practice address
8163 W State Road 56 Ste a
West Baden Springs, IN 47469-7706
Phone
(812) 936-2425
Fax
(812) 936-2599
NPI assigned
Dec 28, 2017
Last updated
Feb 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2023

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

Authorized official

Name
Nancy Radcliff
Title
Ceo
Phone
(812) 723-7118

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X IN Primary

Addresses

Primary practice location

8163 W State Road 56 Ste a
West Baden Springs, IN 47469-7706

Mailing address

PO Box 270
Paoli, IN 47454-0270
Phone (812) 723-7118

Other identifiers 1

IdentifierTypeStateIssuer
201168330AMedicaidIN

Other names 1

  • Valley Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180216001500 IN Part A Provider - Federally Qualified Health Center (FQHC) 5799694360 Practice locations: West Baden Springs, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1841706868. Details of each certification follow.

Federally qualified health center certification: CCN 151020

Legal name
SOUTHERN INDIANA COMMUNITY HEALTH CARE INC
Doing business as
VALLEY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 16, 2018
Last certification
Feb 16, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 20, 1975 in IN
Enrollment address
8163 W State Road 56
Ste a
West Baden Springs, IN 47469-7706

Other NPIs with the same Medicare PAC ID 8

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

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
15D1019805Valley Health8163 W State Road 56, Suite a, West Baden Springs, IN 47469Certificate of waiverFeb 10, 2028

National Provider Directory

National Provider Directory
Tax ID family
Comprehensive Health Care9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Nancy Radcliff Individual Corporate OfficerCeo Jan 1, 2015 50%
Yolanda J Yoder Individual Corporate OfficerCmo Jan 1, 2023
Sue Brock Individual Corporate OfficerCfo Jul 3, 2016 50%
W-2 Managing EmployeeCfo Jul 3, 2016 100%
Evelyn Shellenberger Individual Corporate OfficerChair of Board Jan 1, 2023
Ryan Engleking Individual Corporate OfficerVice Chair of Board Jan 1, 2023
Carrie Rahman Individual Corporate OfficerTreasurer Jan 1, 2023
Martha Nice Individual Corporate OfficerBoard Member Jan 1, 2023
John Noblitt Individual Corporate OfficerBoard Member Jan 1, 2023
Floyd Chupp Individual Corporate OfficerBoard Member Jan 1, 2023
Nick Siler Individual Corporate OfficerBoard Member Jan 1, 2023
Carla McSpadden Individual Corporate OfficerSecretary of Board Jan 1, 2023
Mindy Babbitt Individual Corporate OfficerBoard Member Jan 1, 2023

Owners & managing parties with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1514419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675382400000",
    "number": "1841706868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270",
            "city": "PAOLI",
            "state": "IN",
            "postal_code": "474540270",
            "telephone_number": "812-723-7118",
            "fax_number": "812-723-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8163 W STATE ROAD 56 STE A",
            "city": "WEST BADEN SPRINGS",
            "state": "IN",
            "postal_code": "474697706",
            "telephone_number": "812-936-2425",
            "fax_number": "812-936-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN INDIANA COMMUNITY HEALTH CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-28",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A",
        "authorized_official_last_name": "RADCLIFF",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-723-7118"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201168330A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Baden Springs, IN

Sources for this page

Verify at the official NPI Registry.