NPIMap

Organization Active NPI

Jackson County Schneck Memorial Hospital

Doing business as Schneck Pediatric and Adult Medicine

  • Rural Health Clinic/Center
  • Seymour, IN
National Provider Identifier
1952076069
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
JACKSON COUNTY SCHNECK MEMORIAL HOSPITAL
Doing business as
Schneck Pediatric and Adult Medicine
Practice address
225 S Pine St
2ND FL Jackson Medical Building
Seymour, IN 47274-2367
Phone
(812) 523-7466
Fax
(812) 523-4255
NPI assigned
Aug 11, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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

Authorized official

Name
Mrs. Deborah Mann
Title
VP Finance and Cfo/Treasurer
Phone
(812) 522-2349

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

225 S Pine St
2ND FL Jackson Medical Building
Seymour, IN 47274-2367

Mailing address

411 W Tipton St
Seymour, IN 47274-2363
Phone (812) 522-2349

Other names 1

  • Schneck Pediatric and Adult Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220613000739 IN Part A Provider - Rural Health Clinic 8224004585 Practice locations: Seymour, IN

Rural health clinic certification: CCN 158586

Legal name
JACKSON COUNTY SCHNECK MEMORIAL HOSPITAL
Doing business as
JACKSON MEDICAL BUILDING
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 26, 2024
Last certification
Jan 26, 2024
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
225 S Pine St
Suites 130, 200 & 300
Seymour, IN 47274-2365
Related CCNs
150065

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

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
15D2338729Jackson Medical Building225 S Pine St, Suite 130 Schneck Urology, Seymour, IN 47274Certificate of waiverFeb 16, 2028

National Provider Directory

National Provider Directory
Tax ID family
Schneck Medical Center34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

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

View all 33

Locations

225 S Pine St
Fl 2
Seymour, IN 47274
Phone (812) 523-7466

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Jack L McCory Individual Corporate DirectorBoard Member Jan 1, 2009
Rick L Smith Individual Corporate DirectorBoard Chairman Jan 1, 1998
Andrew B Markel Individual Corporate DirectorBoard Member Jan 1, 2017
Courtney B Kleber Individual Corporate DirectorBoard Member Jan 1, 2013
Deborah a Mann Individual Corporate OfficerVP Finance/Cfo Feb 10, 2014
W-2 Managing EmployeeVP Finance/Cfo Feb 10, 2014
Matthew K Reedy Individual Corporate DirectorBoard Member Jan 1, 2011
Terrence L Gilliland Individual Corporate DirectorBoard Member Jan 1, 2011
Susan D Bevers Individual Corporate DirectorBoard Member Dec 15, 2014
Eric D Fish Individual Corporate OfficerPresident/Ceo Sep 1, 2020
W-2 Managing EmployeePresident/Ceo Sep 1, 2020
Brandon J Harpe Individual Corporate DirectorBoard Member Jan 1, 2020
Robert D Gillaspy Individual Corporate DirectorBoard Member Jan 1, 2017

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 18

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

FacilityTypeRoleSince
Schneck Medical CenterSeymour, IN, CCN 150065 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1966
Schneck Medical CenterSeymour, IN, CCN 15U065 Hospital 5% Or Greater Direct Ownership Interest (100%) Jun 24, 1966
Lutheran Community HomeSeymour, IN, CCN 155715 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 1, 2012
Jul 1, 2012
Hoosier Health & Living CommunityBrownstown, IN, CCN 155611 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2012
Signature Healthcare of MuncieMuncie, IN, CCN 155242 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
5% Or Greater Indirect Ownership Interest (100%)
Adp of the SNF		 May 1, 2013
May 1, 2013
Oct 3, 2025
Signature Healthcare at ParkwoodLebanon, IN, CCN 155378 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2013
Signature Healthcare of Terre HauteTerre Haute, IN, CCN 155426 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2013
Crown Point Health CampusCrown Point, IN, CCN 155637 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2013
Majestic Care of NewburghNewburgh, IN, CCN 155670 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Aug 1, 2013
Majestic Care of LafayetteLafayette, IN, CCN 155243 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Aug 1, 2013
Chateau Rehabilitation and Healthcare CenterFort Wayne, IN, CCN 155249 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Aug 1, 2013
Majestic Care of South BendSouth Bend, IN, CCN 155219 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
5% Or Greater Indirect Ownership Interest (100%)		 Aug 1, 2013
Aug 1, 2013
Bertha D Garten Ketcham Memorial CenterOdon, IN, CCN 155539 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Apr 2, 2013
May 19, 2025
Signature Healthcare of BremenBremen, IN, CCN 155474 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
5% Or Greater Indirect Ownership Interest (100%)
Adp of the SNF		 May 1, 2014
May 1, 2014
Sep 26, 2025
Covered Bridge Health CampusSeymour, IN, CCN 155712 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2014
Stonebridge Health CampusBedford, IN, CCN 155727 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2014
Schneck Medical Center Home Health CareSeymour, IN, CCN 157155 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jun 24, 1940
Schneck Medical Center HospiceSeymour, IN, CCN 151529 Hospice 5% Or Greater Direct Ownership Interest (100%) Jun 24, 1940

NPI Registry JSON

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

{
    "created_epoch": "1628640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670544000000",
    "number": "1952076069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W TIPTON ST",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742363",
            "telephone_number": "812-522-2349",
            "fax_number": "812-522-0792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 S PINE ST",
            "address_2": "2ND FL JACKSON MEDICAL BUILDING",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742367",
            "telephone_number": "812-523-7466",
            "fax_number": "812-523-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON COUNTY SCHNECK MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-11",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "VP FINANCE AND CFO/TREASURER",
        "authorized_official_telephone_number": "812-522-2349",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Schneck Pediatric and Adult Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seymour, IN

Sources for this page

Verify at the official NPI Registry.