MEDICARE: COMMUNITY HOSPITALS OF INDIANA INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	208000000X	Pediatrics Physician
2	2080N0001X	Neonatal-Perinatal Medicine Physician
3	208M00000X	Hospitalist Physician
4	363LN0000X	Neonatal Nurse Practitioner
5	367500000X	Certified Registered Nurse Anesthetist
6	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000637502	OTHER	IN	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225263106
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HOSPITALS OF INDIANA INC

Provider Business Mailing Address
First Line	:	7250 CLEARVISTA DR
Second Line	:	SUITE 120
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-4699
Country	:	US
Telephone Number	:	317-621-2740
Fax Number	:	317-621-5658

Provider Business Practice Location Address
First Line	:	7250 CLEARVISTA DR
Second Line	:	SUITE 120
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-4699
Country	:	US
Telephone Number	:	317-621-2740
Fax Number	:	317-621-5658

Authorized Official
Title or Position	:	CFO
Name	:	JEFFERY KIRKHAM
Credential	:
Telephone Number	:	317-355-5822

Provider Enumeration Date	:	05/21/2009
Last Update Date	:	07/13/2011

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Practice Location Address:

7150 CLEARVISTA DR
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46256-4699

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Practice Location Address:

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1932668209 — JAMIE LYNN NEWMAN RN
Practice Location Address:

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1174221964 — SHANA PORTER RN
Practice Location Address:

7150 CLEARVISTA DR
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46256-4699

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1669152641 — REBECCA GROTE PA-C
Practice Location Address:

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46256-4699

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Directions to “COMMUNITY HOSPITALS OF INDIANA INC ” Practice Location

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