Organization Active NPI

Blue Elk Family Clinic LLC

Doing business as Blue Elk Family Clinic

  • Family Medicine Physician
  • Nashville, IN
National Provider Identifier
1104499649
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BLUE ELK FAMILY CLINIC LLC
Doing business as
Blue Elk Family Clinic
Practice address
50 E Willow St Ste C
Nashville, IN 47448
Phone
(812) 200-8265
Fax
(833) 972-1963
NPI assigned
Jul 22, 2021
Last updated
Jul 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Authorized official

Name
Dr. Lawrence David Sanchez, MDNPI 1841290301
Title
Owner/Physician
Phone
(812) 200-8265

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

50 E Willow St Ste C
Nashville, IN 47448

Mailing address

8410 S 575 W
Morgantown, IN 46160-8492
Phone (414) 640-4945

Other names 1

  • Blue Elk Family Clinic Doing business as

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": "1626912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626912000000",
    "number": "1104499649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8410 S 575 W",
            "city": "MORGANTOWN",
            "state": "IN",
            "postal_code": "461608492",
            "telephone_number": "414-640-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 E WILLOW ST STE C",
            "city": "NASHVILLE",
            "state": "IN",
            "postal_code": "47448",
            "telephone_number": "812-200-8265",
            "fax_number": "833-972-1963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE ELK FAMILY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-22",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A",
        "authorized_official_last_name": "SANCHEZ",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "812-200-8265",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Elk Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nashville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; 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.