Indiana Community Health Medical Center, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

INDIANA COMMUNITY HEALTH MEDICAL CENTER, INC.

Practice address

111 Arrowhead TRL
Bedford, IN 47421-5820

Phone

(812) 203-4718

NPI assigned

Mar 26, 2021

Organization subpart

No

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

Authorized official

Name

Michael KaneNPI 1497891840

Title

Board Member

Phone

(812) 804-3400

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 5

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

• Amy Renee' Burchett

  • Psychiatric/Mental Health Nurse Practitioner
  • Mooresville, IN
  • NPI 1255905246
  Medicare reassignment Care Compare group NPD
• Michael William Kane, MD

  • Psychiatry Physician
  • Bloomington, IN
  • NPI 1497891840

  Family Medicine

  Medicare reassignment NPD Authorized official
• Angela Young

  • Primary Care Nurse Practitioner
  • Bedford, IN
  • NPI 1730960428
  Medicare reassignment Care Compare group NPD
• Kelly J. Anderson, RN, FNP-C

  • Family Nurse Practitioner
  • Bedford, IN
  • NPI 1932437514
  Medicare reassignment NPD
• Jacqueline Daniels, LCSW

  • Clinical Social Worker
  • Bloomington, IN
  • NPI 1205910239
  NPD (past)

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638316800000",
    "number": "1093392870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 ARROWHEAD TRL",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474215820",
            "telephone_number": "812-203-4718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 ARROWHEAD TRL",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474215820",
            "telephone_number": "812-203-4718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA COMMUNITY HEALTH MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-26",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A",
        "authorized_official_last_name": "KANE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "BOARD MEMBER",
        "authorized_official_telephone_number": "812-804-3400"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tassawar Hussain, MD
• Dallyce A Hyatt, RBT
• Sundus Imran, MD
• Indian Creek Township Volunteer Fire Department
• Indiana Center for Recovery Bedford
• Indiana Emergency Physicians LLP
• Indiana Health Centers Inc
• Indiana University Health Bedford, Inc
• Indiana University Health Bedford, Inc
• Indiana University Health Bedford, Inc.

• Family Medicine Physician in Bedford, IN
• Providers in Bedford, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.