NPIMap

Organization Active NPI

St. Vincent Medical Group, Inc.

Doing business as Ascension Medical Group St. Vincent

  • Occupational Medicine Physician
  • Anderson, IN
National Provider Identifier
1063287266
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
Legal business name
ST. VINCENT MEDICAL GROUP, INC.
Doing business as
Ascension Medical Group St. Vincent
Practice address
325 W 38TH St
Anderson, IN 46013-4017
Phone
(765) 648-3356
Fax
(765) 648-3357
NPI assigned
Nov 17, 2023
Last updated
Nov 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Authorized official

Name
Brian MorrisNPI 1659393825
Title
Cfo
Phone
(317) 338-6234

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
Occupational Medicine Physician 2083X0100X NU Primary

Addresses

Primary practice location

325 W 38TH St
Anderson, IN 46013-4017

Mailing address

250 W 96TH St Ste 520
Indianapolis, IN 46260-1317

Other names 2

  • ASCENSION MEDICAL GROUP ST. VINCENT Doing business as
  • WELLNESS - ANDERSON COMMUNITY SCHOOLS Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2294887Anderson Community Schools Wellness Center325 West 38TH Street, Anderson, IN 46013Certificate of waiverNov 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
St Vincent Medical Group Inc44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

Practitioners & affiliated clinicians

Practitioners 1

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": "1700179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700179200000",
    "number": "1063287266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W 96TH ST STE 520",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W 38TH ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460134017",
            "telephone_number": "765-648-3356",
            "fax_number": "765-648-3357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VINCENT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-17",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "317-338-6234"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ASCENSION MEDICAL GROUP ST. VINCENT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WELLNESS - ANDERSON COMMUNITY SCHOOLS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.