NPIMap

Organization Active NPI

Rush Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Rushville, IN
National Provider Identifier
1962462796
Registry record updated Sep 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
RUSH MEMORIAL HOSPITAL
Practice address
1300 N Main St
Rushville, IN 46173-1116
Phone
(765) 932-4111
Fax
(765) 932-7505
NPI assigned
Mar 24, 2006
Last updated
Sep 1, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
RUSH MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 1, 2009

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

Authorized official

Name
Bradley K Smith
Title
Ceo
Phone
(765) 932-7513

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

Addresses

Primary practice location

1300 N Main St
Rushville, IN 46173-1116

Mailing address

1300 N Main St
Rushville, IN 46173-1116
Phone (765) 932-4111

Other identifiers 1

IdentifierTypeStateIssuer
000000098271OtherINSKILLED ANTHEM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071107000303 IN Part A Provider - Critical Access Hospital 7012802754 Practice locations: Rushville, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962462796. Details of each certification follow.

Hospital certification: CCN 15Z304

Legal name
RUSH MEMORIAL HOSPITAL
Doing business as
RUSH MEMORIAL HOSPITAL
Organization structure
GovernmentNon-profit
Enrollment address
1300 N Main St
Rushville, IN 46173-1116
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Gregory J Gundzik MD10 organizations share this tax ID, including this one
Part of
Gregory J Gundzik MD

Other organizations with this tax ID 9

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

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Paul Wilkinson Individual Corporate Director Apr 29, 2019
Mark E Bacon Individual Corporate DirectorBoard Member Jan 1, 2013
Bradley K Smith Individual Corporate DirectorCeo/Administrator Dec 1, 1998
Ashley Kinder Individual Corporate Director May 1, 2020
W-2 Managing Employee May 1, 2020
John M Byrne Individual Corporate DirectorBoard Member Chairperson Jul 1, 1998
Dennis Corn Individual Corporate Director Apr 29, 2019
Rush Memorial Hospital Organization, Rushville, IN Other Jun 12, 2019
Kipland J Burkett Individual Corporate DirectorBoard Member Jan 1, 2010
Bruce W Levi Individual Corporate DirectorBoard Member Jan 1, 2013

Owners & managing parties with NPI records 8

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

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Flatrock River LodgeRushville, IN, CCN 155630 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Aug 1, 2012
White River LodgeBedford, IN, CCN 155631 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Aug 1, 2012
Lodge of the WabashVincennes, IN, CCN 155632 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Aug 1, 2012
Westminster Village Health & RehabTerre Haute, IN, CCN 155221 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
RMH Healthcare Associates Rural Health ClinicRushville, IN, CCN 158539 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 24, 2019
RMH Milroy Primary CareMilroy, IN, CCN 158587 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 29, 2019

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251763200000",
    "number": "1962462796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N MAIN ST",
            "city": "RUSHVILLE",
            "state": "IN",
            "postal_code": "461731116",
            "telephone_number": "765-932-4111",
            "fax_number": "765-932-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N MAIN ST",
            "city": "RUSHVILLE",
            "state": "IN",
            "postal_code": "461731116",
            "telephone_number": "765-932-4111",
            "fax_number": "765-932-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSH MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RUSH MEMORIAL HOSPITAL",
        "enumeration_date": "2006-03-24",
        "last_updated": "2009-09-01",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "765-932-7513"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SKILLED ANTHEM",
            "identifier": "000000098271",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rushville, IN

Sources for this page

Verify at the official NPI Registry.