| Sullivan County Community Hospital | |
|
2186 N Hospital Blvd Ste 2 Sullivan IN 47882-7654 | |
| (812) 268-3318 | |
| Not Available |
| Full Name | Sullivan County Community Hospital |
|---|---|
| Speciality | Clinic/Center |
| Location | 2186 N Hospital Blvd Ste 2, Sullivan, Indiana |
| Authorized Official Name and Position | Jennifer C Ridgway (DIRECTOR OF REVENUE CYCLE) |
| Authorized Official Contact | 8122684311 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sullivan County Community Hospital Po Box 10 Sullivan IN 47882-0010 Ph: () - | Sullivan County Community Hospital 2186 N Hospital Blvd Ste 2 Sullivan IN 47882-7654 Ph: (812) 268-3318 |
| NPI Number | 1497363303 |
|---|---|
| Provider Enumeration Date | 07/16/2020 |
| Last Update Date | 01/02/2024 |
| Medicare PECOS PAC ID | 2466497482 |
|---|---|
| Medicare Enrollment ID | O20200831000591 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497363303 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | William E Heath |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942203104 PECOS PAC ID: 0547155137 Enrollment ID: I20040223000049 |
| Provider Name | Tabitha Simpson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962584375 PECOS PAC ID: 5991896904 Enrollment ID: I20070806000537 |
| Provider Name | Billie J Thurman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285892794 PECOS PAC ID: 6406922319 Enrollment ID: I20080829000018 |
| Provider Name | Dustin C Ellis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962658989 PECOS PAC ID: 3779630926 Enrollment ID: I20090406000246 |
| Provider Name | Debra A Vincent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053545418 PECOS PAC ID: 4385795103 Enrollment ID: I20090707000575 |
| Provider Name | Melissa L Reintjes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265769319 PECOS PAC ID: 3779622139 Enrollment ID: I20091125000283 |
| Provider Name | Tiffany L Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841521630 PECOS PAC ID: 3870787898 Enrollment ID: I20101103000434 |
| Provider Name | Kathleen M Pirtle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770823387 PECOS PAC ID: 8426287418 Enrollment ID: I20140218000177 |
| Provider Name | Stacey L Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912947169 PECOS PAC ID: 6103056080 Enrollment ID: I20140221000739 |
| Provider Name | Holly Laue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255743076 PECOS PAC ID: 0648495549 Enrollment ID: I20140709001985 |
| Provider Name | Jeanna Rennee Lisman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073042131 PECOS PAC ID: 8921378605 Enrollment ID: I20170728001135 |
| Provider Name | Gloria Ann Shields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508324187 PECOS PAC ID: 1355684895 Enrollment ID: I20190523002194 |
| Provider Name | Angela M Shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639730013 PECOS PAC ID: 4789016726 Enrollment ID: I20191113002574 |
| Provider Name | Robert Ealy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720664048 PECOS PAC ID: 2567879158 Enrollment ID: I20210326000976 |
| Provider Name | Hallie Talpas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770176406 PECOS PAC ID: 5496154726 Enrollment ID: I20210519000298 |
| Provider Name | Jennifer Ashley Gooch Holmes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114574191 PECOS PAC ID: 0042609836 Enrollment ID: I20211117000441 |
| Provider Name | Kevin Braun Flinn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558019505 PECOS PAC ID: 0648659854 Enrollment ID: I20220617002221 |
| Provider Name | Kayla Marie Kellams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730813015 PECOS PAC ID: 7315314200 Enrollment ID: I20221107000776 |
| Provider Name | Blake Erin Roseberry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932810751 PECOS PAC ID: 7911371448 Enrollment ID: I20230323000520 |
| Provider Name | Alexandria Clements |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417585837 PECOS PAC ID: 0648661124 Enrollment ID: I20230524002957 |
| Provider Name | Tammy Lynn Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124808803 PECOS PAC ID: 3476901018 Enrollment ID: I20231121001098 |
| Provider Name | Amy Nicole Sparks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578344750 PECOS PAC ID: 5193174308 Enrollment ID: I20231213003323 |
| Provider Name | Angela D Walters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407674195 PECOS PAC ID: 8224560602 Enrollment ID: I20241010003081 |
| Provider Name | Kilby Page Osborn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205350808 PECOS PAC ID: 2567871312 Enrollment ID: I20250115003412 |
| Provider Name | Morgan Beard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093509671 PECOS PAC ID: 4385153071 Enrollment ID: I20250604000458 |
Mso Clinics, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2200 N Section St, Sullivan, IN 47882 Phone: 812-268-4311 Fax: 812-268-2650 | |
Mso Clinics, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2200 N Section St, Sullivan, IN 47882 Phone: 812-268-6292 | |
Sullivan County Community Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2200 N Section St, Sullivan, IN 47882 Phone: 812-268-3318 | |
Emerald Health & Wellness Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 241 W Graysville St, Sullivan, IN 47882 Phone: 812-241-1955 | |
Sullivan County Auditor Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 27 S Main St, Sullivan, IN 47882 Phone: 812-268-0224 Fax: 812-268-0423 | |
Sullivan County Community Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2229 Mary Sherman Dr, Sullivan, IN 47882 Phone: 812-268-3318 |