NPIMap

Organization Active NPI

St. Vincent Heart Center of Indiana, LLC

Doing business as Ascension St. Vincent Heart Center

  • Special Hospital
  • Carmel, IN
National Provider Identifier
1982681748
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Special HospitalTaxonomy code 284300000X
License
06-003284-2 Issued in IN
Legal business name
ST. VINCENT HEART CENTER OF INDIANA, LLC
Doing business as
Ascension St. Vincent Heart Center
Practice address
10580 N Meridian St
Carmel, IN 46290-1028
Phone
(317) 583-5001
Fax
(317) 583-5405
NPI assigned
Dec 22, 2005
Last updated
Aug 25, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Authorized official

Name
Lori Shannon
Title
President/Ceo
Phone
(317) 583-5001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Special Hospital 284300000X 06-003284-2 IN Primary

Addresses

Primary practice location

10580 N Meridian St
Carmel, IN 46290-1028

Mailing address

10580 N Meridian St
Indianapolis, IN 46290-1028
Phone (317) 583-5001

Other identifiers 1

IdentifierTypeStateIssuer
200398730MedicaidIN

Other names 1

  • Ascension St. Vincent Heart Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20021105000002 IN Part A Provider - Hospital 6800704271 Practice locations: Carmel, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982681748. Details of each certification follow.

Hospital certification: CCN 150153

Legal name
ST VINCENT HEART CENTER OF INDIANA LLC
Doing business as
ASCENSION ST VINCENT HEART CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Dec 5, 2002
Last certification
Oct 30, 2004
Beds
107
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Mar 21, 2002 in IN
Enrollment address
10580 N Meridian St
Carmel, IN 46290-1028
Main/Primary Hospital Location
Hospital subgroups
Specialty hospital

Care Compare: Hospital

Medicare Care Compare
Listed as
St Vincent Heart CenterCCN 150153 · All quality measures
Overall star rating
5 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
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 1

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

Locations

2250 Reliable Pkwy
Chicago, IL 60686

10590 N Meridian St
Carmel, IN 46290
Phone (317) 338-6666

Ownership & related parties

All disclosed owners & managing parties 25

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

NameRoleSinceShare
Seth Warren Individual Corporate DirectorDirector Nov 1, 2017
Riverview Hospital Organization, Noblesville, IN Non-profit Other Apr 1, 2017 2%
Brian Morris Individual Corporate DirectorBoard Member Jul 1, 2021
Cynthia Dawn Adams Individual Corporate DirectorBoard Member Nov 1, 2017
Ronald Frick Individual Corporate OfficerSenior Director Finance Apr 7, 2019
Lowry Bayley Individual Corporate DirectorBoard Member Jul 1, 2010
Hancock Regional Hospital Organization, Greenfield, IN Non-profit Other Jul 1, 2017 2%
Daniel a Parod Individual Corporate DirectorBoard Member Jul 1, 2021
Andrew Michael Fouts Individual Corporate DirectorDirector Dec 1, 2016
Jonathan S Nalli Individual Corporate DirectorBoard Member Nov 20, 2014
Michael Joseph Kourany Individual Corporate DirectorDirector Dec 1, 2016
Emily Anne Ruden Individual Corporate DirectorBoard Member Jul 1, 2021
Edward T Fry Individual Corporate DirectorBoard Member Nov 20, 2014
Gregory John Mazanek Individual Corporate DirectorMedical Director Jul 1, 2021
David a Heimansohn Individual Corporate DirectorBoard Member Nov 20, 2014
Kevin D Bower Individual Corporate DirectorBoard Member Jul 1, 2021
James Bernard Hermiller Individual Corporate DirectorBoard Member Nov 20, 2014
Henry County Memorial Hospital Organization, New Castle, IN Non-profit Other Jul 1, 2017 1%
Lori L Shannon Individual Corporate OfficerPresident Nov 20, 2014
W-2 Managing EmployeePresident Apr 7, 2019
Central Indiana Health System Cardiac Services Inc Organization, Indianapolis, IN Corporation 5% Or Greater Direct Ownership Interest Apr 29, 2016 69.74%
Sandeep Anilkumar Joshi Individual Corporate DirectorBoard Member Jul 1, 2021
Ascension Health Organization, St Louis, MO Non-profit Operational/Managerial Control Mar 22, 2002
Peter Andrew Walts Individual Corporate DirectorBoard Member Jul 1, 2021
St Vincent Health Inc Organization, Indianapolis, IN Non-profit Operational/Managerial Control Mar 22, 2006
The Care Group Heart Hospital LLC Organization, Indianapolis, IN LLC 5% Or Greater Direct Ownership Interest Apr 29, 2016 25.26%

Owners & managing parties with NPI records 9

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

Facilities with the same owner 166

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

View all 166

Practitioners & affiliated clinicians

Practitioners 3

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 245

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

View all 245

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598313600000",
    "number": "1982681748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10580 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462901028",
            "telephone_number": "317-583-5001",
            "fax_number": "317-583-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10580 N MERIDIAN ST",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "462901028",
            "telephone_number": "317-583-5001",
            "fax_number": "317-583-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VINCENT HEART CENTER OF INDIANA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-22",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A",
        "authorized_official_last_name": "SHANNON",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "317-583-5001"
    },
    "taxonomies": [
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": "IN",
            "license": "06-003284-2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200398730",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension St. Vincent Heart Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.