Daviess County Hospital

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

01043657A Issued in IN

Legal business name

DAVIESS COUNTY HOSPITAL

Doing business as

North Daviess Medical Clinic

Practice address

202 N West St
Odon, IN 47562-1032

Phone

(812) 636-7300

Fax

(812) 636-8204

NPI assigned

Dec 5, 2006

Last updated

Jan 2, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ken Parsons

Title

President of Board of Directors

Phone

(812) 254-8620

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• North Daviess Medical Clinic Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942368469. Details of each certification follow.

• CCN 153999 Rural health clinic · Active · Details

Rural health clinic certification: CCN 153999

Legal name

DAVIESS COUNTY HOSPITAL

Doing business as

NORTH DAVIESS MEDICAL CLINIC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Dec 17, 2003

Last certification

Jul 28, 2021

Ownership / control type

Non-profit – church related

Organization structure

GovernmentNon-profit

Enrollment address

202 N West St
Odon, IN 47562-1032

Related CCNs

150061

Related certifications (CCN) 4

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

• Daviess County Hospital

  dba Daviess Community Hospital Women's Health Center

  • Gynecology Physician
  • Washington, IN
  • NPI 1275482648

  Parent provider

  Provider of Services
• Daviess County Hospital

  dba Washington Surgical Associates

  • Medical Specialty Clinic/Center
  • Washington, IN
  • NPI 1275745002

  Parent provider

  Provider of Services
• Daviess County Hospital

  dba DCH Diabetes & Endocrinology Clinic

  • Endocrinology, Diabetes & Metabolism Physician
  • Washington, IN
  • NPI 1629337589

  Parent provider

  Provider of Services
• Daviess County Hospital

  dba Daviess Community Hospital

  • General Acute Care Hospital
  • Washington, IN
  • NPI 1861465999

  Parent provider

  Provider of Services

Tax ID family

James P Beck MD45 organizations share this tax ID, including this one

Other organizations with this tax ID 44

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

• Daviess Community Hospital

  dba DCH Spine and Joint Center

  • Chiropractor
  • Washington, IN
  • NPI 1700264967
  NPD tax ID
• Daviess County Hospital

  dba DCH Health Pavilion

  • Rural Health Clinic/Center
  • Washington, IN
  • NPI 1023340965
  NPD tax ID
• Daviess County Hospital

  dba Transitions Behavioral Services

  • Psychologist
  • Washington, IN
  • NPI 1043051014
  NPD tax ID
• Daviess County Hospital

  dba Aperion Care Vincennes

  • Skilled Nursing Facility
  • Vincennes, IN
  • NPI 1083853071
  NPD tax ID
• Daviess County Hospital

  dba Daviess Community Hospital Orthopaedics

  • Orthopaedic Surgery Physician
  • Washington, IN
  • NPI 1083915326
  NPD tax ID
• Daviess County Hospital

  dba Aperion Care Monroe

  • Skilled Nursing Facility
  • Bloomington, IN
  • NPI 1174868822
  NPD tax ID
• Daviess County Hospital

  dba Aperion Care Greenfield

  • Skilled Nursing Facility
  • Greenfield, IN
  • NPI 1215980156
  NPD tax ID
• Daviess County Hospital

  dba DCH Neurology

  • Specialist
  • Washington, IN
  • NPI 1245658699
  NPD tax ID
• Daviess County Hospital

  dba Daviess Community Hospital Women's Health Center

  • Gynecology Physician
  • Washington, IN
  • NPI 1275482648
  NPD tax ID
• Daviess County Hospital

  dba Washington Surgical Associates

  • Medical Specialty Clinic/Center
  • Washington, IN
  • NPI 1275745002
  NPD tax ID
• Daviess County Hospital

  dba Hearthstone Health Campus

  • Skilled Nursing Facility
  • Bloomington, IN
  • NPI 1316375686
  NPD tax ID
• Daviess County Hospital

  dba Daviess Community Hospital

  • Rehabilitation Hospital Unit
  • Washington, IN
  • NPI 1336113513
  NPD tax ID

All disclosed owners & managing parties 7

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

All facility ownership & control disclosures 27

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Practitioners 1

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.

• William Glenn Czerwinski, M.S. LMHC

  • Mental Health Counselor
  • Dupont, WA
  • NPI 1942321500
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609545600000",
    "number": "1942368469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 N WEST ST",
            "city": "ODON",
            "state": "IN",
            "postal_code": "475621032",
            "telephone_number": "812-636-7300",
            "fax_number": "812-636-8204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 N WEST ST",
            "city": "ODON",
            "state": "IN",
            "postal_code": "475621032",
            "telephone_number": "812-636-7300",
            "fax_number": "812-636-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIESS COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2021-01-02",
        "certification_date": "2021-01-02",
        "status": "A",
        "authorized_official_last_name": "PARSONS",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "PRESIDENT OF BOARD OF DIRECTORS",
        "authorized_official_telephone_number": "812-254-8620"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "IN",
            "license": "01043657A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200152680A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dchdirect@direct.dchsystem.com",
            "affiliation": "N",
            "address_1": "421 E Van Trees St",
            "city": "Washington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "475012948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "North Daviess Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Daviess Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gretchen Ann Childress, LCSW
• Diane J. Heckley PC
• Dr T Scott Manis PC (Odon Family Chirpractic)
• Melvin J Graber
• Daniel Lee Grotzinger, DC
• Michelle L Harman, D.D.S.

• Rural Health Clinic/Center in Odon, IN
• Providers in Odon, IN by specialty
• Rural Health Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.