NPIMap

Organization Active NPI

Community Hospital of in, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Indianapolis, IN
National Provider Identifier
1902067440
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
416 Issued in IN
Legal business name
COMMUNITY HOSPITAL OF IN, INC
Practice address
6626 E 75TH Street
Ste 500
Indianapolis, IN 46250-2890
Phone
(317) 621-7561
Fax
(317) 355-6096
NPI assigned
Jun 18, 2008
Last updated
Apr 5, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY HOSPITAL OF INAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Authorized official

Name
Anthony Javorka, COO
Title
Authorized Official
Phone
(317) 621-1591

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 416 IN Primary

Addresses

Primary practice location

6626 E 75TH Street
Ste 500
Indianapolis, IN 46250-2890

Mailing address

6626 E 75TH Street
Ste 500
Indianapolis, IN 46250

Other identifiers 1

IdentifierTypeStateIssuer
100270530BMedicaidIN

Other names 1

  • Gallahue Mental Health Services Other name

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
15D0924316Community Hospital Network6626 E 75TH Street, Suite 400, Indianapolis, IN 46250Certificate of waiverApr 21, 2027

National Provider Directory

National Provider Directory
Tax ID family
David Felkins MD37 organizations share this tax ID, including this one
Part of
David Felkins MD

Other organizations with this tax ID 36

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

View all 36

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491350400000",
    "number": "1902067440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH STREET",
            "address_2": "STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6626 E 75TH STREET",
            "address_2": "STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890",
            "telephone_number": "317-621-7561",
            "fax_number": "317-355-6096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HOSPITAL OF IN, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HOSPITAL OF IN",
        "enumeration_date": "2008-06-18",
        "last_updated": "2017-04-05",
        "status": "A",
        "authorized_official_last_name": "JAVORKA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "317-621-1591",
        "authorized_official_credential": "COO"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IN",
            "license": "416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100270530B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gallahue Mental Health Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.