NPIMap

Organization Active NPI

Fayette Memorial Hospital Association Inc

Doing business as Fayette Regional Health System

  • Clinical Medical Laboratory
  • Connersville, IN
National Provider Identifier
1902125883
Registry record updated May 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
10-005059-1 Issued in IN
Legal business name
FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC
Doing business as
Fayette Regional Health System
Practice address
1941 Virginia Ave
Connersville, IN 47331-2833
Phone
(765) 827-7704
Fax
(765) 827-7726
NPI assigned
May 18, 2010
Last updated
May 18, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2010

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

Authorized official

Name
Michelle M Henry
Title
Supervisor Patient Financial SVCS
Phone
(765) 827-7700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 10-005059-1 IN Primary

Addresses

Primary practice location

1941 Virginia Ave
Connersville, IN 47331-2833

Mailing address

1941 Virginia Ave
Connersville, IN 47331-2833
Phone (765) 827-7700

Other identifiers 1

IdentifierTypeStateIssuer
100268210MedicaidIN

Other names 1

  • Fayette Regional Health System Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fayette Memorial Hospital Association Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1274140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274140800000",
    "number": "1902125883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 VIRGINIA AVE",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473312833",
            "telephone_number": "765-827-7700",
            "fax_number": "765-827-7796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 VIRGINIA AVE",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473312833",
            "telephone_number": "765-827-7704",
            "fax_number": "765-827-7726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-18",
        "last_updated": "2010-05-18",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SUPERVISOR PATIENT FINANCIAL SVCS",
        "authorized_official_telephone_number": "765-827-7700"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IN",
            "license": "10-005059-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100268210",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fayette Regional Health System",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Connersville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2010; 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.