NPIMap

Organization Active NPI

Marion General Hospital

Doing business as Marion General Hospital Ambulance Service

  • Land Ambulance
  • Marion, IN
National Provider Identifier
1932295466
Registry record updated Jul 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
06-005011-1 Issued in IN
Legal business name
MARION GENERAL HOSPITAL
Doing business as
Marion General Hospital Ambulance Service
Practice address
441 N Wabash Ave
Marion, IN 46952-2612
Phone
(765) 662-1441
Fax
(765) 651-7351
NPI assigned
Oct 4, 2006
Last updated
Jul 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2015

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

Authorized official

Name
Mr. Paul Usher
Title
Ceo
Phone
(765) 662-4684

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 06-005011-1 IN Primary

Addresses

Primary practice location

441 N Wabash Ave
Marion, IN 46952-2612

Mailing address

441 N Wabash Ave
Marion, IN 46952-2612
Phone (765) 662-1441

Other identifiers 1

IdentifierTypeStateIssuer
100461130AMedicaidIN

Other names 1

  • Marion General Hospital Ambulance Service Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080829000136 IN Part A Provider - Hospital 9133023625 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gas City, IN; Marion, IN; Swayzee, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932295466. Details of each certification follow.

Hospital certification: CCN 150011

Legal name
MARION GENERAL HOSPITAL
Doing business as
MARION GENERAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Aug 16, 2018
Beds
99
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Mar 24, 1910 in IN
Enrollment address
441 N Wabash Ave
Marion, IN 46952-2612
Other Hospital Practice Location
Hospital subgroups
Acute care

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

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Marion General HospitalCCN 150011 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Jeffrey D Breckenridge19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Sirajabid Khatib Individual Corporate DirectorBoard Member Jul 1, 2019
Cynthia Futrell Individual Corporate OfficerChief Nursing Officer Jul 23, 2015
Mohammad Nabi Sharif Individual Corporate DirectorBoard Member Jul 1, 2013
Dean B Ricks Individual Corporate DirectorSecretary of Medical Staff Dec 1, 2023
Barbara Ihrke Individual Corporate DirectorBoard Member Jul 1, 2024
Steven E Berry Individual Corporate DirectorBoard Vice Chair Jul 1, 2014
Kevin R Cates Individual Corporate DirectorBoard Secretary Jul 1, 2015
Shankaran Srikanth Individual Corporate DirectorVice Chairman Medical Staff Jul 1, 2009
Lezlie Winter Individual Corporate DirectorBoard Member Jul 1, 2018
Anthony Roberts Individual Corporate OfficerChief Financial Officer Jan 3, 2021
Stephen M Keller Individual Corporate DirectorBoard Member Jul 1, 2021
Stephanie Hilton Siebert Individual Corporate OfficerChief Administrative Officer May 1, 2015
Operational/Managerial ControlPresident/Chief Executive Officer May 1, 2015
Elizabeth E Gutierrez Individual Corporate DirectorBoard Treasurer Jul 1, 2021
Timothy J Dailey Individual Corporate DirectorBoard Chair Jul 1, 2014
Marion General Hospital Organization, Marion, IN Corporation Operational/Managerial Control Nov 19, 2007
James M Orrell Individual Corporate DirectorChief of Medical Staff Jul 1, 2014

Owners & managing parties with NPI records 9

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

Practitioners & affiliated clinicians

Affiliated clinicians 407

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 407

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437350400000",
    "number": "1932295466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 N WABASH AVE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522612",
            "telephone_number": "765-662-1441",
            "fax_number": "765-651-7351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 N WABASH AVE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522612",
            "telephone_number": "765-662-1441",
            "fax_number": "765-651-7351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARION GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2015-07-20",
        "status": "A",
        "authorized_official_last_name": "USHER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "765-662-4684",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IN",
            "license": "06-005011-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100461130A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marion General Hospital Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marion, IN

Sources for this page

Verify at the official NPI Registry.