Memorial Hospital Of South Bend is an Air Ambulance based in South Bend, IN and is specialized in Air Transport. Memorial Hospital Of South Bend practices in South Bend, IN. The NPI Number for Memorial Hospital Of South Bend is 1295772093 and holds a License No. 005053 (Indiana).
The current practice location address for Memorial Hospital Of South Bend is 615 N Michigan St, South Bend, IN and can be reached out via phone at 574-647-1000. You can also correspond with Memorial Hospital Of South Bend through the mailing address at 615 N MICHIGAN ST, SOUTH BEND, IN - 46601-1033 (mailing address contact number: ).
Location: 615 N Michigan St, South Bend, IN, 46601-1033
Provider Profile Details
NPI Number
1295772093
Provider Name
Memorial Hospital Of South Bend
Credential
Provider Entity Type
Organization
Address
615 N Michigan St, South Bend, IN, 46601-1033
Phone Number
574-647-1000
Fax Number
Provider Enumeration Date
06/01/2006
Last Update Date
03/12/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100239890A | 05 | IN | |
| 100269890B | 05 | IN | |
| 000000097671 | 01 | IN | ANTHEM PIN |
| 200318490A | 05 | IN | |
| 100269910A | 05 | IN | |
| 200713710A | 05 | IN | |
| 200378380A | 05 | IN |
Provider Business Practice Location Address Details
Address
615 N Michigan St
City
State
Zip
46601-1033
Phone Number
574-647-1000
Fax Number
Provider Business Mailing Address Details
Address
615 N Michigan St
City
State
Zip
46601-1033
Phone Number
Fax Number
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Emergency Medicine
Speciality
-
Taxonomy
License No.
005053 (Indiana)
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Provider's Taxonomy Details 2
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Occupational Therapist
Speciality
-
Taxonomy
License No.
005053 (Indiana)
Definition
An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Community Health
Taxonomy
License No.
06-005053 (Indiana)
Definition
Definition to come...
Provider's Taxonomy Details 4
Type
Hospital Units
Classification
Psychiatric Unit
Speciality
-
Taxonomy
License No.
06-005053 (Indiana)
Definition
In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning.
Provider's Taxonomy Details 5
Type
Hospital Units
Classification
Rehabilitation Unit
Speciality
-
Taxonomy
License No.
()
Definition
In general, a distinct unit of a general acute care hospital that provides care encompassing a comprehensive array of restoration services for the disabled and all support services necessary to help patients attain their maximum functional capacity. Source: AHA Annual Survey p. A10 1996 AHA Guide. For Medicare, a distinct part of a general acute care hospital providing inpatient rehabilitation services that meets the following requirements. Rehabilitation Units have in effect a preadmission screening procedure under which each prospective patient's condition and medical history are reviewed to determine whether the patient is likely to benefit significantly from an intensive inpatient program or assessment; ensure that the patients receive close medical supervision and furnish, through the use of qualified personnel, rehabilitation nursing, physical therapy and occupational therapy, plus, as needed, speech therapy, social services or psychological services and orthotic and prosthetic services; have a plan of treatment for each inpatient that is established, reviewed, and revised as needed by a physician in consultation with other professional personnel who provide services to the patient; use a coordinated multidisciplinary team approach in the rehabilitation of each inpatient, as documented by periodic clinical entries made in the patient's medical record to note the patient's status in relationship to goal attainment, and that team conferences are held at least every two weeks to determine the appropriateness of treatment; have a director of rehabilitation who provides services to the unit and its inpatients for at least 20 hours a week, is a doctor of medicine or osteopathy, is licensed under State law to practice medicine or surgery, and has had, after completing a one-year hospital internship at least two years of training or experience in the medical management of inpatients requiring rehabilitation services.
Provider's Taxonomy Details 6
Type
Hospitals
Classification
General Acute Care Hospital
Speciality
-
Taxonomy
License No.
005053 (Indiana)
Definition
An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity.
Provider's Taxonomy Details 7
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
-
Taxonomy
License No.
005053 (Indiana)
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
Provider's Taxonomy Details 8
Type
Transportation Services
Classification
Ambulance
Speciality
Air Transport
Taxonomy
License No.
005053 (Indiana)
Definition
Definition to come...
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