NPIMap

Organization Active NPI

North Central Indiana Ear Nose and Throat, PC

  • Specialist
  • Logansport, IN
National Provider Identifier
1073660866
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
NORTH CENTRAL INDIANA EAR NOSE AND THROAT, PC
Practice address
800 Fulton St
Logansport, IN 46947-1577
Phone
(574) 753-2222
Fax
(574) 753-0522
NPI assigned
Jan 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. David George Short, DONPI 1134184153
Title
Physician
Phone
(574) 753-2222

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X IN Primary

Addresses

Primary practice location

800 Fulton St
Logansport, IN 46947-1577

Mailing address

800 Fulton St
Logansport, IN 46947-1577
Phone (574) 753-2222

Other identifiers 1

IdentifierTypeStateIssuer
1134184153OtherINNPI

National Provider Directory

National Provider Directory

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": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073660866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 FULTON ST",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471577",
            "telephone_number": "574-753-2222",
            "fax_number": "574-753-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 FULTON ST",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471577",
            "telephone_number": "574-753-2222",
            "fax_number": "574-753-0522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CENTRAL INDIANA EAR NOSE AND THROAT, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHORT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "574-753-2222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1134184153",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Logansport, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.