NPIMap

Organization Active NPI

Community Hospital of Anderson & Madison County, Inc

  • General Acute Care Hospital
  • Anderson, IN
National Provider Identifier
1972500452
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
COMMUNITY HOSPITAL OF ANDERSON & MADISON COUNTY, INC
Practice address
1515 N Madison Ave
Anderson, IN 46011-3453
Phone
(765) 298-3300
Fax
(765) 298-5800
NPI assigned
Jun 30, 2005
Last updated
Oct 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Authorized official

Name
Holly Millard
Title
Finance
Phone
(317) 355-5860

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

1515 N Madison Ave
Anderson, IN 46011-3453

Mailing address

6233 Reliable Parkway
Chicago, IL 60686-0001
Phone (765) 298-3300

Other identifiers 6

IdentifierTypeStateIssuer
000000097753OtherINANTHEM
100102820AMedicaidIN
200073560AMedicaidIN
0745740001OtherINMEDICARE PART B DME
200817400AMedicaidIN
100269520AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040325000156 IN Part B Supplier - Clinic/Group Practice 5698667822 Receives reassigned benefits from 162 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Indianapolis, IN; Zionsville, IN; Terre Haute, IN; South Bend, IN; Plymouth, IN; Muncie, IN; Mishawaka, IN; Marion, IN…
O20071212000399 IN Part A Provider - Hospital 4880503218 Practice locations: Anderson, IN; Pendleton, IN; Muncie, IN; Alexandria, IN
O20100930036648 IN DME Supplier - HospitalDME Supplier - Medical Supply Company 4880503218 Practice locations: Anderson, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972500452. Details of each certification follow.

Hospital certification: CCN 150113

Legal name
COMMUNITY HOSPITAL OF ANDERSON & MADISON COUNTY, INC
Doing business as
COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Aug 15, 2012
Beds
137
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
1515 N Madison Ave
Anderson, IN 46011-3453
Main/Primary Hospital Location
Hospital subgroups
Acute care

Other NPIs on the same Medicare enrollment 9

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Community Hospital of Anderson and Madison CountyCCN 150113 · 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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 4

Organizations listed as members of this organization in the National Provider Directory.

Locations

1130 Medical Arts Blvd
Anderson, IN 46011
Phone (765) 298-5181

1210 Medical Arts Blvd
Ste 101
Anderson, IN 46011
Phone (765) 298-4276

1210 Medical Arts Blvd
Ste 117
Anderson, IN 46011
Phone (765) 298-1798

1309 Monticello Dr
Anderson, IN 46011
Phone (765) 298-5598

1601 Medical Arts Blvd
Ste 101
Anderson, IN 46011
Phone (765) 298-5702

3125 S Scatterfield Rd
Ste 130
Anderson, IN 46013
Phone (765) 298-3500

3125 S Scatterfield Rd
Ste 140
Anderson, IN 46013
Phone (765) 298-4659

7150 Clearvista Dr
Ste 1
Indianapolis, IN 46256

391 S Heritage Way
Ste 125
Pendleton, IN 46064
Phone (765) 744-1606

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Jason R Fahrlander Individual Corporate DirectorBoard Director Apr 1, 2025 100%
W-2 Managing EmployeeAd; Apr 1, 2025 100%
Julie Hettinga Individual Corporate OfficerBoard Vice Chair Apr 1, 2025 100%
Community Health Network Inc Organization, Indianapolis, IN For-profit, Chain home office 5% Or Greater Direct Ownership Interest Dec 19, 2020
Operational/Managerial Control Dec 16, 2019 100%
Moayyed Moallem Individual Corporate DirectorBoard Director Apr 1, 2025 100%
Bryan a Mills Individual Corporate OfficerPresident & Ceo Jul 1, 2009
W-2 Managing EmployeePresident & Ceo Jul 1, 2009
Operational/Managerial ControlPresident & Ceo Jul 1, 2009
Elizabeth Tharp Individual Corporate OfficerPresident & Ceo Jul 16, 2012 100%
Corporate DirectorPresident & Ceo Jul 16, 2012 100%
W-2 Managing EmployeePresident & Ceo Jul 16, 2012 100%
Leroy Quashie Individual Corporate DirectorBoard Director Apr 1, 2025 100%
William O'Neal Individual Corporate DirectorBoard Director Apr 1, 2025 100%
Community Hospital of Anderson & Madison County, Inc Organization, Anderson, IN Corporation Operational/Managerial Control Jan 1, 2015 100%
Other Jan 1, 2015 100%
Marie Morris Individual Corporate OfficerBoard Chair Apr 1, 2025 100%
Treva Bostic Individual Corporate DirectorBoard Director Apr 1, 2005 100%
Tom Dickey Individual Corporate DirectorBoard Director Apr 1, 2025
Jason Jameson Individual Corporate OfficerBoard Secretary Apr 1, 2025 100%
Thomas Short Individual Corporate DirectorBoard Director Apr 1, 2025 100%
Tony I McHerron Individual Corporate DirectorBoard Director Apr 1, 2025 100%
Thomas V Thomas Individual Corporate DirectorBoard Director Apr 1, 2025 100%
Arthur Leak Individual Corporate DirectorBoard Director Apr 1, 2025 100%
Holly Millard Individual Corporate DirectorInterim Cfo Feb 14, 2020
W-2 Managing EmployeeInterim Cfo Feb 14, 2020 100%

Owners & managing parties with NPI records 5

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

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 9

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.

Affiliated clinicians 518

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

View all 518

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1972500452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6233 RELIABLE PARKWAY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606860001",
            "telephone_number": "765-298-3300",
            "fax_number": "765-298-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 N MADISON AVE",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460113453",
            "telephone_number": "765-298-3300",
            "fax_number": "765-298-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HOSPITAL OF ANDERSON & MADISON COUNTY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "MILLARD",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "FINANCE",
        "authorized_official_telephone_number": "317-355-5860"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000097753",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100102820A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200073560A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B DME",
            "identifier": "0745740001",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200817400A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100269520A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

Verify at the official NPI Registry.