Individual provider Active NPI

Alvan L Eller, MD

  • Family Medicine Physician
  • Flora, IN
National Provider Identifier
1003885930
Registry record updated Sep 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01022721A Issued in IN
Practice address
203 N Division St
Flora, IN 46929-1024
Phone
(765) 448-8000
Fax
(765) 448-8335
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01022721A IN Primary

Addresses

Primary practice location

203 N Division St
Flora, IN 46929-1024

Mailing address

PO Box 5545
Lafayette, IN 47903-5545
Phone (765) 448-8000

Other identifiers 5

IdentifierTypeStateIssuer
100097620MedicaidIN
EL17837008MedicaidIN
10825048OtherINCAQH NUMBER
000000183530OtherINANTHEM PROVIDER NUMBER
9057268OtherINPHCS PID NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01022721AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arnett Clinic, LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222646400000",
    "number": "1003885930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5545",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479035545",
            "telephone_number": "765-448-8000",
            "fax_number": "765-448-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 N DIVISION ST",
            "city": "FLORA",
            "state": "IN",
            "postal_code": "469291024",
            "telephone_number": "765-448-8000",
            "fax_number": "765-448-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLER",
        "first_name": "ALVAN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2008-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01022721A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100097620",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EL17837008",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH NUMBER",
            "identifier": "10825048",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000183530",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS PID NUMBER",
            "identifier": "9057268",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flora, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; 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.