NPIMap

Community Hospital of Anderson & Madison County, Inc

Organization Active NPI General Acute Care Hospital · Anderson, IN

NPI 1972500452 · NPPES record last updated Oct 20, 2022

Key facts

NPI
1972500452
Entity type
Organization (NPI type 2)
Primary specialty
General Acute Care Hospital 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
Organization subpart
No

Authorized official

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

Owners & managing parties with NPI records 5

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

Other NPIs on the same Medicare enrollment 9

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

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.

Facilities with the same owner 4

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

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 518

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

View all 518

Medicare Care Compare: Hospital

Listed as
Community Hospital of Anderson and Madison County CCN 150113
Overall star rating
★★★☆☆ 3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (3 enrollments) in IN

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
Corporation · Non-profit
Enrollment address
1515 N Madison Ave
Anderson, IN 46011-3453
Main/Primary Hospital Location
Hospital subgroups
Acute care

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 Director
Board Director		 Apr 1, 2025 100%
W-2 Managing Employee
Ad;		 Apr 1, 2025 100%
Julie Hettinga
Individual 		Corporate Officer
Board 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 Director
Board Director		 Apr 1, 2025 100%
Bryan a Mills
Individual 		Corporate Officer
President & Ceo		 Jul 1, 2009
W-2 Managing Employee
President & Ceo		 Jul 1, 2009
Operational/Managerial Control
President & Ceo		 Jul 1, 2009
Elizabeth Tharp
Individual 		Corporate Officer
President & Ceo		 Jul 16, 2012 100%
Corporate Director
President & Ceo		 Jul 16, 2012 100%
W-2 Managing Employee
President & Ceo		 Jul 16, 2012 100%
Leroy Quashie
Individual 		Corporate Director
Board Director		 Apr 1, 2025 100%
William O'Neal
Individual 		Corporate Director
Board 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 Officer
Board Chair		 Apr 1, 2025 100%
Treva Bostic
Individual 		Corporate Director
Board Director		 Apr 1, 2005 100%
Tom Dickey
Individual 		Corporate Director
Board Director		 Apr 1, 2025
Jason Jameson
Individual 		Corporate Officer
Board Secretary		 Apr 1, 2025 100%
Thomas Short
Individual 		Corporate Director
Board Director		 Apr 1, 2025 100%
Tony I McHerron
Individual 		Corporate Director
Board Director		 Apr 1, 2025 100%
Thomas V Thomas
Individual 		Corporate Director
Board Director		 Apr 1, 2025 100%
Arthur Leak
Individual 		Corporate Director
Board Director		 Apr 1, 2025 100%
Holly Millard
Individual 		Corporate Director
Interim Cfo		 Feb 14, 2020
W-2 Managing Employee
Interim Cfo		 Feb 14, 2020 100%

Medicare enrollment records

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 - Hospital
DME Supplier - Medical Supply Company		 4880503218 Practice locations: Anderson, IN

National Provider Directory

Locations

2116 S Park Ave
Alexandria, IN 46001
Phone (765) 298-4000

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

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

1201A Medical Arts Blvd
Anderson, IN 46011

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

1601 Medical Arts Blvd
Anderson, IN 46011
Phone (765) 298-2004

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

1601 Medical Arts Blvd
Ste 52
Anderson, IN 46011
Phone (765) 298-3470

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

7150 Clearvista Dr
Ste 1
Indianapolis, IN 46256

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

Specialties & licenses

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

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

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 20, 2022.

{
    "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": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100102820A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200817400A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B DME",
            "identifier": "0745740001",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200073560A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000097753",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100269520A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, IN

All providers in Anderson, IN · General Acute Care Hospital in Indiana

Sources for this page

Verify at the official NPI Registry.