Healthcare Provider Details

I. General information

NPI: 1063640258
Provider Name (Legal Business Name): HENDRICKS COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2009
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E MAIN ST
DANVILLE IN
46122-1948
US

IV. Provider business mailing address

1100 SOUTHFIELD DR SUITE 1370
PLAINFIELD IN
46168-4498
US

V. Phone/Fax

Practice location:
  • Phone: 317-718-4676
  • Fax: 317-718-2476
Mailing address:
  • Phone: 317-837-5571
  • Fax: 317-837-5580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: HEATHER RUTHERFORD
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 317-837-5566