Organization Active NPI

American Health Network of Indiana, LLC

  • Family Medicine Physician
  • Edinburgh, IN
National Provider Identifier
1114028842
Registry record updated Jan 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Practice address
201 W Main Cross St
Edinburgh, IN 46124-1346
Phone
(812) 526-0261
Fax
(812) 526-3118
NPI assigned
Sep 26, 2006
Last updated
Jan 21, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
AMERICAN HEALTH NETWORK OF INDIANA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 21, 2008

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

Authorized official

Name
Ben H Park, MD
Title
President and Ceo
Phone
(317) 580-6307

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
Hematology & Oncology Physician 207RH0003X NU
Obstetrics & Gynecology Physician 207V00000X NU
Orthopaedic Surgery Physician 207X00000X NU
Physical Medicine & Rehabilitation Physician 208100000X NU
Neurology Physician 2084N0400X NU
Pain Medicine (Psychiatry & Neurology) Physician 2084P2900X NU
Nuclear Radiology Physician 2085N0904X NU
Diagnostic Radiology Physician 2085R0202X NU
Diagnostic Ultrasound Physician 2085U0001X NU
Surgery Physician 208600000X NU
Colon & Rectal Surgery Physician 208C00000X NU
Pain Medicine Physician 208VP0000X NU
Interventional Pain Medicine Physician 208VP0014X NU

Addresses

Primary practice location

201 W Main Cross St
Edinburgh, IN 46124-1346

Mailing address

PO Box 190
Franklin, IN 46131-0190
Phone (812) 526-0261

Other identifiers 1

IdentifierTypeStateIssuer
153838OtherINRURAL HEALTH MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031124000691 IN Part B Supplier - Clinic/Group Practice 9830093533 Receives reassigned benefits from 230 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
American Health Network of Indiana LLC

Locations

201 W Main Cross St
Edinburgh, IN 46124
Phone (812) 526-0261

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200873600000",
    "number": "1114028842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "FRANKLIN",
            "state": "IN",
            "postal_code": "461310190",
            "telephone_number": "812-526-0261",
            "fax_number": "812-526-3118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W MAIN CROSS ST",
            "city": "EDINBURGH",
            "state": "IN",
            "postal_code": "461241346",
            "telephone_number": "812-526-0261",
            "fax_number": "812-526-3118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN HEALTH NETWORK OF INDIANA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMERICAN HEALTH NETWORK OF INDIANA, LLC",
        "enumeration_date": "2006-09-26",
        "last_updated": "2008-01-21",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "BEN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "317-580-6307",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RURAL HEALTH MEDICARE",
            "identifier": "153838",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburgh, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2008; 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.