Indiana Neuro-Ophthalmology & Center for Balance

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

01045654 Issued in IN

Legal business name

INDIANA NEURO-OPHTHALMOLOGY & CENTER FOR BALANCE

Practice address

3721 Rome Dr
Suite a
Lafayette, IN 47905-4408

Phone

(765) 807-7100

Fax

(765) 807-7101

NPI assigned

Dec 19, 2006

Organization subpart

No

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

Authorized official

Name

Scott Sanders, MDNPI 1902800576

Title

President

Phone

(765) 807-7100

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• BalanceMD Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CAIFCD

Practitioners 7

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

• Scott K Sanders, MD, PHD

  • Neurology Physician
  • Lafayette, IN
  • NPI 1902800576
  Medicare reassignment Care Compare group NPD Authorized official
• Stephanie Elaine Ford, PHYSICAL THERAPIST

  • Physical Therapist
  • Crawfordsville, IN
  • NPI 1932244597
  Medicare reassignment Care Compare group NPD
• Sandra Michelle Bratton, AU.D

  • Audiologist
  • Lafayette, IN
  • NPI 1407815715
  Medicare reassignment NPD
• Connor Slavich, AU.D.

  • Audiologist
  • Danville, IN
  • NPI 1548876428
  Medicare reassignment NPD
• Ashly Gray, AGNP-C

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1801254081

  IN

  Medicare reassignment NPD
• Michelle A Koley, M.A., CCC-A

  • Audiologist
  • Westfield, IN
  • NPI 1851593578
  Medicare reassignment
• Warren H Palmer

  • Family Psychologist
  • Indianapolis, IN
  • NPI 1275508293
  NPD (past)

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569974400000",
    "number": "1104989011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 ROME DR",
            "address_2": "SUITE A",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054408",
            "telephone_number": "765-807-7100",
            "fax_number": "765-807-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 ROME DR",
            "address_2": "SUITE A",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054408",
            "telephone_number": "765-807-7100",
            "fax_number": "765-807-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA NEURO-OPHTHALMOLOGY & CENTER FOR BALANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2019-10-02",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "765-807-7100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "01045654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000507081",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ENCORE",
            "identifier": "10019219",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9239622",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "DF9084",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5776298",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BalanceMD",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BalanceMD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Neurology Physician in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Neurology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; 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.