| Perry County Memorial Hospital | |
|
18485 State Rd 37 Leopold IN 47551-8072 | |
| (812) 843-3038 | |
| (812) 843-3084 |
| Full Name | Perry County Memorial Hospital |
|---|---|
| Speciality | Clinic/Center |
| Location | 18485 State Rd 37, Leopold, Indiana |
| Authorized Official Name and Position | Jared Stimpson (CEO) |
| Authorized Official Contact | 8125470170 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Perry County Memorial Hospital 8885 State Road 237 Tell City IN 47586-8567 Ph: (812) 547-7011 | Perry County Memorial Hospital 18485 State Rd 37 Leopold IN 47551-8072 Ph: (812) 843-3038 |
| NPI Number | 1215928536 |
|---|---|
| Provider Enumeration Date | 11/04/2005 |
| Last Update Date | 11/18/2024 |
| Medicare PECOS PAC ID | 6204867559 |
|---|---|
| Medicare Enrollment ID | O20050825000962 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215928536 | NPI | - | NPPES |
| 15D1043196 | Other | IN | CLIA |
| 78904927 | Medicaid | KY | |
| 65944290 | Medicaid | KY | |
| 000000371434 | Other | IN | ANTHEM |
| 200531240A | Medicaid | IN |
| Provider Name | Andrea Marie Polk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427368208 PECOS PAC ID: 4284821901 Enrollment ID: I20101207001205 |
| Provider Name | Jerry K Pearson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1043252166 PECOS PAC ID: 8921036740 Enrollment ID: I20140520000812 |
| Provider Name | Samantha Polk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417357542 PECOS PAC ID: 8426370388 Enrollment ID: I20141203001258 |
| Provider Name | Beth Sharp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457893844 PECOS PAC ID: 3870876022 Enrollment ID: I20170213002419 |
| Provider Name | Shawn Sikka |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1366797201 PECOS PAC ID: 4385918788 Enrollment ID: I20180612000059 |
| Provider Name | Krystle Susan Hahus |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275974255 PECOS PAC ID: 7911149471 Enrollment ID: I20180920002013 |