NPIMap

Organization Active NPI

Otolaryngology Associates LLC

  • Otolaryngology Physician
  • Avon, IN
National Provider Identifier
1023130333
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
1115 Ronald Reagan Pkwy
Ste 255
Avon, IN 46123-6913
Phone
(317) 844-7059
Fax
(317) 573-4352
NPI assigned
Apr 6, 2007
Last updated
Jul 20, 2010By the provider in NPPES
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.NPI 1740347194
Title
President
Phone
(317) 844-7059

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X Primary

Addresses

Primary practice location

1115 Ronald Reagan Pkwy
Ste 255
Avon, IN 46123-6913

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
200838770DMedicaidIN

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

1115 Ronald Reagan Pkwy
Ste 255
Avon, IN 46123

Practitioners & affiliated clinicians

Practitioners 10

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": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279584000000",
    "number": "1023130333",
    "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": "1115 RONALD REAGAN PKWY",
            "address_2": "STE 255",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461236913",
            "telephone_number": "317-844-7059",
            "fax_number": "317-573-4352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTOLARYNGOLOGY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "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": "",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200838770D",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, 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.