NPIMap

Organization Active NPI

Otolaryngology Associates LLC

  • Otolaryngology Physician
  • Mooresville, IN
National Provider Identifier
1013039593
Registry record updated Jul 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
OTOLARYNGOLOGY ASSOCIATES LLC
Practice address
1001 Hadley Rd
Mooresville, IN 46158-1794
Phone
(317) 844-7059
Fax
(317) 573-4352
NPI assigned
Apr 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2010

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

Authorized official

Name
Thomas H Fairchild, M.D.
Title
President
Phone
(317) 844-7059

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

1001 Hadley Rd
Mooresville, IN 46158-1794

Mailing address

9002 N Meridian St
Ste 222
Indianapolis, IN 46260-5350
Phone (317) 573-4370

Other identifiers 1

IdentifierTypeStateIssuer
100057100EMedicaidIN

National Provider Directory

National Provider Directory
Tax ID family
Otolaryngology Associates LLC14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

9002 N Meridian St
Ste 222
Indianapolis, IN 46260
Phone (317) 573-4370

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279584000000",
    "number": "1013039593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9002 N MERIDIAN ST",
            "address_2": "STE 222",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462605350",
            "telephone_number": "317-573-4370",
            "fax_number": "317-819-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 HADLEY RD",
            "city": "MOORESVILLE",
            "state": "IN",
            "postal_code": "461581794",
            "telephone_number": "317-844-7059",
            "fax_number": "317-573-4352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTOLARYNGOLOGY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2010-07-20",
        "status": "A",
        "authorized_official_last_name": "FAIRCHILD",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-844-7059",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100057100E",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; 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.