EVANSVILLE STATE HOSPITAL
NPI 1326169871
Intermediate Care Facility, Intellectual Disabilities in Evansville, IN

NPI Status: Active since April 03, 2007

Contact Information

3400 LINCOLN AVENUE
EVANSVILLE, IN
ZIP 47714
Phone: (812) 469-6800
Fax: (812) 469-6847

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  • Organization
  • Intermediate Care Facility, Intellectual...
  • CLIA Number: 15D0035620
  • CLIA Cert. Type: Hospital
  • CLIA Exp. Date: 08-31-2026

About EVANSVILLE STATE HOSPITAL

This page provides the complete NPI Profile along with additional information for Evansville State Hospital, a provider established in Evansville, Indiana operating as a Intermediate Care Facility, Intellectual Disabilities. The healthcare provider is registered in the NPI registry with number 1326169871 assigned on April 2007. The practitioner's primary taxonomy code is 315P00000X. The provider is registered as an organization and their NPI record was last updated 15 years ago. The provider's is doing business as Evansville State Hospital. The authorized official of this NPI record is Cathe Fulcher (Superintendent)

NPI
1326169871
Provider Legal Name
STATE OF INDIANA AUDITOR OF STATE
Other Organization Name
EVANSVILLE STATE HOSPITAL
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
3400 LINCOLN AVENUE EVANSVILLE, IN 47714
Location Phone
(812) 469-6800
Location Fax
(812) 469-6847
Mailing Address
3400 LINCOLN AVENUE EVANSVILLE, IN 47714
Mailing Phone
(812) 469-6800
Mailing Fax
(812) 469-6847
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-03-2007
Last Update Date
08-30-2010
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Intermediate Care Facility, Intellectual Disabilities

Taxonomy Code
315P00000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
An intermediate care facility providing services for individuals with intellectual disabilities.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

CATHE FULCHER

Authorized Official Title
SUPERINTENDENT
Authorized Official Phone
(812) 469-6800

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
100272090MEDICAID (05)IN 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
15D0035620
Facility Type
Hospital
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
JENNIFER STONE
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Evansville State Hospital to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for EVANSVILLE STATE HOSPITAL

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1326169871
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
23462618814
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 4 + 6 + 2 + 6 + 1 + 8 + 8 + 1 + 4 + 24 = 69
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 69 = 11

The NPI number 1326169871 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1922094481STATE OF INDIANA AUDITOR OF STATE
Organization
Psychiatric Hospital3400 LINCOLN AVENUE
EVANSVILLE, IN 47714
(812) 469-6800
1235250788STATE OF INDIANA AUDITOR OF STATE
Organization
Psychiatric Hospital3400 LINCOLN AVENUE
EVANSVILLE, IN 47714
(812) 469-6800

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1326169871, enumerated in the NPI registry as an "organization" on April 03, 2007

The provider is located at 3400 Lincoln Avenue Evansville, In 47714 and the phone number is (812) 469-6800

This medical organization specializes in Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The provider's CLIA number is 15D0035620 for a "hospital" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on April 03, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.