Organization Active NPI

Family ENT Specialists, LLC

  • Otolaryngology Physician
  • Evansville, IN
National Provider Identifier
1023523610
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
01073983A Issued in IN
Legal business name
FAMILY ENT SPECIALISTS, LLC
Practice address
706 N Burkhardt Rd
Evansville, IN 47715-2740
Phone
(812) 465-2727
Fax
(812) 297-8954
NPI assigned
Dec 5, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Authorized official

Name
Allison K Royer, MDNPI 1023243771
Title
President
Phone
(812) 465-2727

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 01073983A IN Primary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 01065502A IN

Addresses

Primary practice location

706 N Burkhardt Rd
Evansville, IN 47715-2740

Mailing address

PO Box 3276
Evansville, IN 47731-3276
Phone (812) 473-0181

Other identifiers 1

IdentifierTypeStateIssuer
201324210AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180430002131 IN Part B Supplier - Clinic/Group Practice 5193089076 Receives reassigned benefits from 2 practitioners
Practice locations: Evansville, IN

National Provider Directory

National Provider Directory

Locations

909A S Kenmore Dr
Evansville, IN 47714
Phone (812) 760-5528

909 S Kenmore Dr
#A
Evansville, IN 47714
Phone (812) 773-8773

706 N Burkhardt Rd
Ste A
Evansville, IN 47715

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17219/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1512432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640822400000",
    "number": "1023523610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3276",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477313276",
            "telephone_number": "812-473-0181",
            "fax_number": "812-473-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 N BURKHARDT RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152740",
            "telephone_number": "812-465-2727",
            "fax_number": "812-297-8954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY ENT SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-05",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A",
        "authorized_official_last_name": "ROYER",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-465-2727",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "01073983A",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "01065502A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201324210A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.