St Paul Hermitage Home

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

060003911 Issued in IN

Legal business name

ST PAUL HERMITAGE HOME

Practice address

501 N 17TH Avenue
Beech Grove, IN 46107

Phone

(317) 786-2261

Fax

(317) 782-1411

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Maureen Therese Cooney

Title

Bookkeeper

Phone

(317) 786-2261

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1871605055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N 17TH AVENUE",
            "city": "BEECH GROVE",
            "state": "IN",
            "postal_code": "46107",
            "telephone_number": "317-786-2261",
            "fax_number": "317-782-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N 17TH AVENUE",
            "city": "BEECH GROVE",
            "state": "IN",
            "postal_code": "46107",
            "telephone_number": "317-786-2261",
            "fax_number": "317-782-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST PAUL HERMITAGE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "COONEY",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_middle_name": "THERESE",
        "authorized_official_title_or_position": "BOOKKEEPER",
        "authorized_official_telephone_number": "317-786-2261"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IN",
            "license": "060003911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100274990A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claudet C Smith, MD
• Jennifer Keller Smith, RD
• Sonus-USA, Inc.
• James Michael Souers, DDS
• Kaelyn Nikolle Spivey
• St. Francis Hospital
• St. Francis Hospital & Health Centers
• St. Francis Hospital & Health Centers
• St. Francis Hospital and Health Centers
• St. Francis Hospital and Health Centers

• Nursing Facility/Intermediate Care Facility in Beech Grove, IN
• Providers in Beech Grove, IN by specialty
• Nursing Facility/Intermediate Care Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.