NPIMap

Organization Active NPI

Anesthesia Care of Bloomington PC

  • Anesthesiology Physician
  • Bloomington, IN
National Provider Identifier
1093990541
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ANESTHESIA CARE OF BLOOMINGTON PC
Practice address
4011 S Monroe Medical Park Blvd
Bloomington, IN 47403-8000
Phone
(812) 825-1111
NPI assigned
Jan 3, 2008
Last updated
May 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Authorized official

Name
Alan D Hillard
Title
Cfo
Phone
(336) 899-1412

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X Primary

Addresses

Primary practice location

4011 S Monroe Medical Park Blvd
Bloomington, IN 47403-8000

Mailing address

PO Box 10483
Birmingham, AL 35202-0483
Phone (205) 322-1808

Other identifiers 1

IdentifierTypeStateIssuer
200889750AMedicaidIN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 34

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.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1093990541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10483",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352020483",
            "telephone_number": "205-322-1808",
            "fax_number": "205-322-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 S MONROE MEDICAL PARK BLVD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474038000",
            "telephone_number": "812-825-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANESTHESIA CARE OF BLOOMINGTON PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "HILLARD",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "336-899-1412"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200889750A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.