NPIMap

Organization Active NPI

Surgical Associates Southern Indiana, PSC

  • Surgery Physician
  • Jeffersonville, IN
National Provider Identifier
1013902394
Registry record updated Mar 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
50003241A Issued in IN
Legal business name
SURGICAL ASSOCIATES SOUTHERN INDIANA, PSC
Practice address
301 Gordon Gutmann Blvd
Suite 401
Jeffersonville, IN 47130-3764
Phone
(812) 282-0637
Fax
(812) 283-6330
NPI assigned
Sep 13, 2005
Last updated
Mar 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2010

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

Authorized official

Name
Dr. Daniel C Macmillan, M.D.NPI 1780679050
Title
President/Director
Phone
(812) 282-0637

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 50003241A IN Primary

Addresses

Primary practice location

301 Gordon Gutmann Blvd
Suite 401
Jeffersonville, IN 47130-3764

Mailing address

301 Gordon Gutmann Blvd
Suite 401
Jeffersonville, IN 47130-3739
Phone (812) 282-0637

Other identifiers 2

IdentifierTypeStateIssuer
50003241AOtherINMED. CORP. CERTIFICATION
200105360AMedicaidIN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1126569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269907200000",
    "number": "1013902394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 GORDON GUTMANN BLVD",
            "address_2": "SUITE 401",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303739",
            "telephone_number": "812-282-0637",
            "fax_number": "812-283-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 GORDON GUTMANN BLVD",
            "address_2": "SUITE 401",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303764",
            "telephone_number": "812-282-0637",
            "fax_number": "812-283-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL ASSOCIATES SOUTHERN INDIANA, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-13",
        "last_updated": "2010-03-30",
        "status": "A",
        "authorized_official_last_name": "MACMILLAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT/DIRECTOR",
        "authorized_official_telephone_number": "812-282-0637",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "50003241A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED. CORP. CERTIFICATION",
            "identifier": "50003241A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200105360A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.