NPIMap

Organization Active NPI

Board of Trustees of Welborn Clinic

Doing business as Welborn Clinic IDTF Princeton

  • Diagnostic Radiology Physician
  • Princeton, IN
National Provider Identifier
1003954884
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
BOARD OF TRUSTEES OF WELBORN CLINIC
Doing business as
Welborn Clinic IDTF Princeton
Practice address
401 N Richland Creek Dr
Princeton, IN 47670-3536
Phone
(812) 386-6650
NPI assigned
Feb 2, 2007
Last updated
Nov 27, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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

Authorized official

Name
Dr. David D Christeson, MDNPI 1265508451
Title
Ceo
Phone
(812) 426-6626

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X NU
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

401 N Richland Creek Dr
Princeton, IN 47670-3536

Mailing address

401 N Richland Creek Dr
Princeton, IN 47670-3536
Phone (812) 386-6650

Other names 1

  • Welborn Clinic IDTF Princeton Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196121600000",
    "number": "1003954884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N RICHLAND CREEK DR",
            "city": "PRINCETON",
            "state": "IN",
            "postal_code": "476703536",
            "telephone_number": "812-386-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N RICHLAND CREEK DR",
            "city": "PRINCETON",
            "state": "IN",
            "postal_code": "476703536",
            "telephone_number": "812-386-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARD OF TRUSTEES OF WELBORN CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-11-27",
        "status": "A",
        "authorized_official_last_name": "CHRISTESON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-426-6626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Welborn Clinic IDTF Princeton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Princeton, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.