MEDICARE: HENDRICKS COUNTY HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1104927557
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HENDRICKS COUNTY HOSPITAL

Provider Business Mailing Address
First Line	:	1100 SOUTHFIELD DR
Second Line	:	SUITE 1370
City	:	PLAINFIELD
State	:	IN
Zip	:	46168-4498
Country	:	US
Telephone Number	:	317-837-5571
Fax Number	:	317-837-5580

Provider Business Practice Location Address
First Line	:	1100 SOUTHFIELD DR STE 1210
Second Line	:
City	:	PLAINFIELD
State	:	IN
Zip	:	46168-4499
Country	:	US
Telephone Number	:	317-839-4114
Fax Number	:	317-839-7749

Authorized Official
Title or Position	:	CREDENTIALING COORDINATOR
Name	:	HEATHER RUTHERFORD
Credential	:
Telephone Number	:	317-837-5566

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	11/17/2025

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Directions to “HENDRICKS COUNTY HOSPITAL ” Practice Location

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