NPIMap

Organization Active NPI

Emergency Medical Group, Inc.

  • Emergency Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1073570529
Registry record updated Apr 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
EMERGENCY MEDICAL GROUP, INC.
Practice address
1701 N Senate Blvd
Methodist Hosp ER Dept
Indianapolis, IN 46202-1239
Phone
(317) 962-4836
Fax
(317) 962-8646
NPI assigned
Apr 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2009

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

Authorized official

Name
Dr. Charles Shufflebarger, MDNPI 1982647079
Title
Executive Director
Phone
(317) 962-4836

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
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary
Medical Toxicology (Emergency Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207PT0002X

Addresses

Primary practice location

1701 N Senate Blvd
Methodist Hosp ER Dept
Indianapolis, IN 46202-1239

Mailing address

250 N Shadeland Ave
Suite 200
Indianapolis, IN 46219-4959
Phone (317) 962-4836

Other identifiers 1

IdentifierTypeStateIssuer
100235770MedicaidIN

National Provider Directory

National Provider Directory
Tax ID family
Emegency Med Group Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

2302 Reliable Pkwy
Chicago, IL 60686

Practitioners & affiliated clinicians

Practitioners 59

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

View all 59

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238976000000",
    "number": "1073570529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "address_2": "SUITE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959",
            "telephone_number": "317-962-4836",
            "fax_number": "317-962-8646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N SENATE BLVD",
            "address_2": "METHODIST HOSP ER DEPT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021239",
            "telephone_number": "317-962-4836",
            "fax_number": "317-962-8646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGENCY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-27",
        "last_updated": "2009-04-06",
        "status": "A",
        "authorized_official_last_name": "SHUFFLEBARGER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "317-962-4836",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207PT0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Medical Toxicology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100235770",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2009; 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.