Organization Active NPI

Rising Sun Medical Center Inc

  • Family Medicine Physician
  • Rising Sun, IN
National Provider Identifier
1124072137
Registry record updated Aug 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RISING SUN MEDICAL CENTER INC
Practice address
230 6TH St
Rising Sun, IN 47040-1114
Phone
(812) 438-2555
Fax
(812) 438-1236
NPI assigned
May 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2017

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

Authorized official

Name
Tom Fuller
Title
President
Phone
(812) 537-8200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

230 6TH St
Rising Sun, IN 47040-1114

Mailing address

PO Box 639352
Cincinnati, OH 45263-9352
Phone (812) 537-8241

Other identifiers 4

IdentifierTypeStateIssuer
1619948015OtherININDIVIDUAL NPI
1841262011OtherININDIVIDUAL NPI
000000037297OtherINANTHEM
200203240AMedicaidIN

National Provider Directory

National Provider Directory

Locations

1037 W Main St
Vevay, IN 47043
Phone (812) 427-2737

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503878400000",
    "number": "1124072137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639352",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639352",
            "telephone_number": "812-537-8241",
            "fax_number": "812-537-1041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 6TH ST",
            "city": "RISING SUN",
            "state": "IN",
            "postal_code": "470401114",
            "telephone_number": "812-438-2555",
            "fax_number": "812-438-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISING SUN MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2017-08-28",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-537-8200"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1619948015",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1841262011",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000037297",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200203240A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rising Sun, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2017; 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.