NPIMap

Organization Active NPI

St. Luke's Medical Ministry

  • Rural Health Clinic/Center
  • Scottsburg, IN
National Provider Identifier
1912923285
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ST. LUKE'S MEDICAL MINISTRY
Practice address
1441 N Gardner St
Scottsburg, IN 47170-7751
Phone
(812) 752-4055
Fax
(812) 752-4188
NPI assigned
Jul 13, 2006
Last updated
Mar 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Authorized official

Name
Andrea Gibson, DNPNPI 1326652751
Title
Practice Manager
Phone
(812) 752-4055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1441 N Gardner St
Scottsburg, IN 47170-7751

Mailing address

PO Box 677
Scottsburg, IN 47170-0677
Phone (812) 752-4055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031110000520 IN Part B Supplier - Clinic/Group Practice 5890608475 Receives reassigned benefits from 6 practitioners
Practice locations: Scottsburg, IN
O20060823000306 IN Part A Provider - Rural Health Clinic 5890608475 Practice locations: Scottsburg, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912923285. Details of each certification follow.

Rural health clinic certification: CCN 153882

Legal name
ST. LUKE'S MEDICAL MINISTRY
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 28, 2006
Last certification
Aug 6, 2019
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Jan 28, 1999 in IN
Enrollment address
1441 N. Gardner Street
Scottsburg, IN 47170-7761

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
15D0886498St Luke's Medical Ministry1441 North Gardner Medical Specialty Center, Scottsburg, IN 47170Provider-performed microscopyMay 19, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Larry Hunefeld Individual 5% Or Greater Direct Ownership Interest Jan 28, 2006
Corporate Director Jan 28, 2006
W-2 Managing Employee Jan 28, 2006

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772668800000",
    "number": "1912923285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 677",
            "city": "SCOTTSBURG",
            "state": "IN",
            "postal_code": "471700677",
            "telephone_number": "812-752-4055",
            "fax_number": "812-752-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 N GARDNER ST",
            "city": "SCOTTSBURG",
            "state": "IN",
            "postal_code": "471707751",
            "telephone_number": "812-752-4055",
            "fax_number": "812-752-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S MEDICAL MINISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "812-752-4055",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsburg, IN

Sources for this page

Verify at the official NPI Registry.