NPIMap

Organization Active NPI

Evansville Integrative Medicine PC

  • Family Medicine Physician
  • Evansville, IN
National Provider Identifier
1104166503
Registry record updated Feb 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01059401A Issued in IN
Legal business name
EVANSVILLE INTEGRATIVE MEDICINE PC
Practice address
3700 Bellemeade Ave
Ste 105
Evansville, IN 47714-0102
Phone
(812) 401-4222
Fax
(812) 401-5722
NPI assigned
Feb 21, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2013

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

Authorized official

Name
Dr. Anne Butsch
Title
Owner
Phone
(812) 401-4222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 01059401A IN Primary

Addresses

Primary practice location

3700 Bellemeade Ave
Ste 105
Evansville, IN 47714-0102

Mailing address

3700 Bellemeade Ave
Ste 105
Evansville, IN 47714-0102
Phone (812) 401-4222

Other identifiers 1

IdentifierTypeStateIssuer
1780600353OtherINNPI (PHYSICIAN)

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361836800000",
    "number": "1104166503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 BELLEMEADE AVE",
            "address_2": "STE 105",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140102",
            "telephone_number": "812-401-4222",
            "fax_number": "812-401-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 BELLEMEADE AVE",
            "address_2": "STE 105",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140102",
            "telephone_number": "812-401-4222",
            "fax_number": "812-401-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANSVILLE INTEGRATIVE MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-21",
        "last_updated": "2013-02-26",
        "status": "A",
        "authorized_official_last_name": "BUTSCH",
        "authorized_official_first_name": "ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-401-4222",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01059401A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI (PHYSICIAN)",
            "identifier": "1780600353",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; 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.