Active NPI
Madison County Community Health Center
- Body Imaging Physician
- Anderson, IN
National Provider Identifier
1013363308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Body Imaging Physician
- Legal business name
- MADISON COUNTY COMMUNITY HEALTH CENTER
- Practice address
- 1547 Ohio Ave
Anderson, IN 46016-1917 - Phone
- (765) 641-7499
- Fax
- (765) 356-4647
- NPI assigned
- May 5, 2016
- Organization subpart
- Yes
- Parent organization
- MADISON COUNTY COMMUNITY HEALTH CENTER
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Anthony Malone
- Title
- Ceo
- Phone
- (765) 641-7499
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Body Imaging Physician | 2085B0100X | Primary |
Addresses
Primary practice location
1547 Ohio Ave
Anderson, IN 46016-1917
Mailing address
1547 Ohio Ave
Anderson, IN 46016-1917
Phone (765) 641-7499
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200271310A | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Federally qualified health center certification: CCN 151825
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- MADISON COUNTY COMMUNITY HEATLH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jun 4, 2003
- Last certification
- Jun 4, 2003
- Ownership / control type
- Non-profit – other
- Facility address
- 1547 Ohio Ave PO Box 349
Anderson, IN 46016
National Provider Directory
National Provider Directory- Tax ID family
- Madison County Community
- Part of
- Madison County Community
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Mental Health Counselor
- Anderson, IN
- NPI 1902242647
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462406400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1462406400000",
"number": "1013363308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1547 OHIO AVE",
"city": "ANDERSON",
"state": "IN",
"postal_code": "460161917",
"telephone_number": "765-641-7499",
"fax_number": "765-356-4647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1547 OHIO AVE",
"city": "ANDERSON",
"state": "IN",
"postal_code": "460161917",
"telephone_number": "765-641-7499",
"fax_number": "765-356-4647"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MADISON COUNTY COMMUNITY HEALTH CENTER",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MADISON COUNTY COMMUNITY HEALTH CENTER",
"enumeration_date": "2016-05-05",
"last_updated": "2016-05-05",
"status": "A",
"authorized_official_last_name": "MALONE",
"authorized_official_first_name": "ANTHONY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "765-641-7499"
},
"taxonomies": [
{
"code": "2085B0100X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Radiology, Body Imaging",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200271310A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Anderson, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.