Jackson County Schneck Memorial Hospital

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

JACKSON COUNTY SCHNECK MEMORIAL HOSPITAL

Practice address

411 W Tipton St
5TH FL 2007 Tower Main Hospital Building
Seymour, IN 47274-2363

Phone

(812) 523-5864

Fax

(812) 523-5835

NPI assigned

Apr 6, 2021

Organization subpart

No

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

Authorized official

Name

Deborah Mann

Title

VP Finance and Cfo/Treasurer

Phone

(812) 522-2349

Specialties & licenses 1

Addresses

Other names 1

• Schneck Obstetrics and Gynecology Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Rural health clinic certification: CCN 158566

Legal name

JACKSON COUNTY SCHNECK MEMORIAL HOSPITAL

Doing business as

SCHNECK OBSTETRICS & GYNECOLOGY

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Apr 22, 2022

Last certification

Apr 22, 2022

Ownership / control type

Non-profit – church related

Organization structure

OtherNon-profit

Enrollment address

411 W Tipton St.
5TH Floor; 2007 Tower Main Building
Seymour, IN 47274-2363

Related CCNs

150065

Related certifications (CCN) 1

Facilities connected through Provider of Services related, parent or unit certification numbers.

• Jackson County Schneck Memorial Hospital

  • General Acute Care Hospital
  • Seymour, IN
  • NPI 1699738088

  Parent provider

  Provider of Services

Tax ID family

Schneck Medical Center34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

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

• Jackson County Schneck Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Seymour, IN
  • NPI 1043332927
  NPD tax ID
• Jackson County Schneck Memorial Hospital

  • Skilled Nursing Facility
  • Brownstown, IN
  • NPI 1043561970
  NPD tax ID
• Jackson County Schneck Memorial Hospital

  • Skilled Nursing Facility
  • Terre Haute, IN
  • NPI 1083955124
  NPD tax ID
• Jackson County Schneck Memorial Hospital

  • Home Health Agency
  • Seymour, IN
  • NPI 1164485553
  NPD tax ID
• Jackson County Schneck Memorial Hospital

  • Skilled Nursing Facility
  • Lebanon, IN
  • NPI 1184965550
  NPD tax ID
• Jackson County Schneck Memorial Hospital

  • Community/Retail Pharmacy
  • Seymour, IN
  • NPI 1205780145
  NPD tax ID
• Jackson County Schneck Memorial Hospital

  • Skilled Nursing Facility
  • Odon, IN
  • NPI 1205839826
  NPD tax ID
• Jackson County Schneck Memorial Hospital

  • Skilled Nursing Facility
  • Bremen, IN
  • NPI 1275959751
  NPD tax ID
• Jackson County Schneck Memorial Hospital

  • Rural Health Clinic/Center
  • Seymour, IN
  • NPI 1285213272
  NPD tax ID
• Jackson County Schneck Memorial Hospital

  • Rural Health Clinic/Center
  • Seymour, IN
  • NPI 1295310753
  NPD tax ID
• Jackson County Schneck Memorial Hospital

  • Corporate Health Clinic/Center
  • Seymour, IN
  • NPI 1336685536
  NPD tax ID
• Jackson County Schneck Memorial Hospital

  • Long Term Care Pharmacy
  • Brownstown, IN
  • NPI 1366396103
  NPD tax ID

Locations

All disclosed owners & managing parties 11

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

Owners & managing parties with NPI records 1

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

• Eric Duane Fish, M.D.

  • Obstetrics & Gynecology Physician
  • Seymour, IN
  • NPI 1831121599

  Corporate Officer, W-2 Managing Employee

  CMS ownership

All facility ownership & control disclosures 18

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Melanie Lehr, FNP

  • Family Nurse Practitioner
  • Seymour, IN
  • NPI 1922681329
  NPD (past)
• Kaitlin Uebel, CNM

  • Advanced Practice Midwife
  • Seymour, IN
  • NPI 1902604085
  NPD (past)

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617667200000",
    "number": "1891374880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W TIPTON ST",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742363",
            "telephone_number": "812-522-2349",
            "fax_number": "812-522-0792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W TIPTON ST",
            "address_2": "5TH FL 2007 TOWER MAIN HOSPITAL BUILDING",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742363",
            "telephone_number": "812-523-5864",
            "fax_number": "812-523-5835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON COUNTY SCHNECK MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "VP FINANCE AND CFO/TREASURER",
        "authorized_official_telephone_number": "812-522-2349"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Schneck Obstetrics and Gynecology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jackson County Schneck Memorial Hospital
• Jackson County Schneck Memorial Hospital
• Jackson County Schneck Memorial Hospital
• Jackson County Schneck Memorial Hospital
• Jackson County Schneck Memorial Hospital
• Jackson County Schneck Memorial Hospital
• Jackson County Schneck Memorial Hospital
• Jackson Park Physicians, PC
• Amy Elizabeth Jackson, PA C
• Elizabeth Anne Jackson, FNP

• Rural Health Clinic/Center in Seymour, IN
• Providers in Seymour, IN by specialty
• Rural Health Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.