Provider Demographics
NPI:1104998624
Name:COLUMBUS REGIONAL HOSPITAL
Entity type:Organization
Organization Name:COLUMBUS REGIONAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-376-5255
Mailing Address - Street 1:PO BOX 776755
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6755
Mailing Address - Country:US
Mailing Address - Phone:812-379-4441
Mailing Address - Fax:812-376-5963
Practice Address - Street 1:2400 17TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-5351
Practice Address - Country:US
Practice Address - Phone:812-379-4441
Practice Address - Fax:812-376-5963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN273R00000X, 273Y00000X, 341600000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No273R00000XHospital UnitsPsychiatric Unit
No273Y00000XHospital UnitsRehabilitation Unit
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100293890AMedicaid
IN000000054333OtherBLUE CROSS
IN100454010AMedicaid
IN100268190AMedicaid
IN100268200AMedicaid
IN150112Medicare Oscar/Certification
IN100268200AMedicaid
IN100454010AMedicaid
IN940160Medicare Oscar/Certification