NPIMap

Organization Active NPI

Daviess County Hospital

Doing business as Daviess Community Hospital Clinic of Jasper

  • Multi-Specialty Clinic/Center
  • Jasper, IN
National Provider Identifier
1942030804
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
DAVIESS COUNTY HOSPITAL
Doing business as
Daviess Community Hospital Clinic of Jasper
Practice address
4115 Mannheim Rd
Jasper, IN 47546-2964
Phone
(812) 254-2760
NPI assigned
Aug 6, 2024
Last updated
Aug 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Authorized official

Name
Mrs. Chastity Lynne Fox
Title
PFS Supervisor
Phone
(812) 254-8620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

4115 Mannheim Rd
Jasper, IN 47546-2964

Mailing address

PO Box 760
Washington, IN 47501-0760
Phone (812) 254-2760

Other names 1

  • Daviess Community Hospital Clinic of Jasper Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100420000663 IN Part B Supplier - Clinic/Group Practice 1557271665 Receives reassigned benefits from 112 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Washington, IN; Jasper, IN

Other NPIs on the same Medicare enrollment 12

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

National Provider Directory

National Provider Directory
Tax ID family
Daviess County Hospital44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

Practitioners & affiliated clinicians

Practitioners 3

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": "1722902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722902400000",
    "number": "1942030804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 760",
            "city": "WASHINGTON",
            "state": "IN",
            "postal_code": "475010760",
            "telephone_number": "812-254-2760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4115 MANNHEIM RD",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475462964",
            "telephone_number": "812-254-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIESS COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-06",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "CHASTITY",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "PFS SUPERVISOR",
        "authorized_official_telephone_number": "812-254-8620",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Daviess Community Hospital Clinic of Jasper",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jasper, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.