NPIMap

Organization Active NPI

Kidney and Hypertension Center of in PC

  • Nephrology Physician
  • Greencastle, IN
National Provider Identifier
1083766695
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
01052996 Issued in IN
Legal business name
KIDNEY AND HYPERTENSION CENTER OF IN PC
Practice address
1542 S Bloomington St
Greencastle, IN 46135-2212
Phone
(812) 232-3900
Fax
(812) 232-3955
NPI assigned
Jan 17, 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
Sherif Elassal, MD
Title
Owner
Phone
(812) 232-3900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RN0300X 01052996 IN Primary

Addresses

Primary practice location

1542 S Bloomington St
Greencastle, IN 46135-2212

Mailing address

3740 S 4TH St
Terre Haute, IN 47802-5507
Phone (812) 232-3900

National Provider Directory

National Provider Directory
Tax ID family
Kidney and Hypertension Center of in4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083766695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 S 4TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478025507",
            "telephone_number": "812-232-3900",
            "fax_number": "812-232-3955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 S BLOOMINGTON ST",
            "city": "GREENCASTLE",
            "state": "IN",
            "postal_code": "461352212",
            "telephone_number": "812-232-3900",
            "fax_number": "812-232-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY AND HYPERTENSION CENTER OF IN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELASSAL",
        "authorized_official_first_name": "SHERIF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-232-3900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "IN",
            "license": "01052996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greencastle, 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.