Clinical Colleagues of Indiana PC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

CLINICAL COLLEAGUES OF INDIANA PC

Practice address

500 Arcade Ave Ste 100
Elkhart, IN 46514-2478

Phone

(800) 927-0002

Fax

(603) 893-8886

NPI assigned

Jul 24, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kurt Zumwalt

Title

President

Phone

(410) 429-6115

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582243200000",
    "number": "1003469495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1765 E NINE MILE RD STE 1-229",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325145479",
            "telephone_number": "410-429-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ARCADE AVE STE 100",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465142478",
            "telephone_number": "800-927-0002",
            "fax_number": "603-893-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL COLLEAGUES OF INDIANA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-24",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A",
        "authorized_official_last_name": "ZUMWALT",
        "authorized_official_first_name": "KURT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-429-6115"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cleveland Township
• Cleveland Township Volunteer Fire Department Inc
• Karen M. Cleveland, RD, CD
• James W Clifton, LCSW, LMHC,LMFT, LCA
• Alexys Cline
• Elizabeth Cloud, NP
• Troy D Clouse, MD
• Antoinette Sue Coalson, NP
• Makayla Cochran
• Alyssa Rae Coco, OTR/L

• All providers in Elkhart, IN
• Certified Registered Nurse Anesthetist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.