NPIMap

Organization Active NPI

Indiana University Health Ball Memorial Physicians, Inc.

Doing business as IU Health Ball Memorial Physicians

  • Family Medicine Physician
  • Hartford City, IN
National Provider Identifier
1043539232
Registry record updated Oct 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
INDIANA UNIVERSITY HEALTH BALL MEMORIAL PHYSICIANS, INC.
Doing business as
IU Health Ball Memorial Physicians
Practice address
400 Pilgrim Blvd
Hartford City, IN 47348-1382
Phone
(765) 348-5776
Fax
(765) 348-3865
NPI assigned
May 27, 2010
Last updated
Oct 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2013

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

Authorized official

Name
Janet L Vangets
Title
Director/Officer
Phone
(765) 751-3311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

400 Pilgrim Blvd
Hartford City, IN 47348-1382

Mailing address

250 N Shadeland Ave
Attn: Carol Boyd
Indianapolis, IN 46219-4959
Phone (317) 963-0413

Other identifiers 2

IdentifierTypeStateIssuer
200986050 GMedicaidIN
DQ6230OtherINRR MEDICARE

Other names 1

  • IU Health Ball Memorial Physicians Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031110000505 IN Part B Supplier - Clinic/Group Practice 9537072640 Receives reassigned benefits from 661 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Indiana University Phy Inc16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

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": "1274918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381708800000",
    "number": "1043539232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "address_2": "ATTN: CAROL BOYD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959",
            "telephone_number": "317-963-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PILGRIM BLVD",
            "city": "HARTFORD CITY",
            "state": "IN",
            "postal_code": "473481382",
            "telephone_number": "765-348-5776",
            "fax_number": "765-348-3865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA UNIVERSITY HEALTH BALL MEMORIAL PHYSICIANS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-27",
        "last_updated": "2013-10-14",
        "status": "A",
        "authorized_official_last_name": "VANGETS",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR/OFFICER",
        "authorized_official_telephone_number": "765-751-3311"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200986050 G",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DQ6230",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IU Health Ball Memorial Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hartford City, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2013; 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.