St. Vincent Physician Network, LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

ST. VINCENT PHYSICIAN NETWORK, LLC

Practice address

4 Rebel Drive
Lynn, IN 47355-8947

Phone

(765) 874-2390

NPI assigned

Sep 20, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

D Bruce Haga

Title

Vice President

Phone

(317) 338-7419

Specialties & licenses 1

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• St. Vincent Physician Network, LLC

  • Orthopaedic Surgery Physician
  • Frankfort, IN
  • NPI 1720234883

  Member Of

  NPD member

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124126933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9588 VALPARAISO COURT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 REBEL DRIVE",
            "city": "LYNN",
            "state": "IN",
            "postal_code": "473558947",
            "telephone_number": "765-874-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VINCENT PHYSICIAN NETWORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAGA",
        "authorized_official_first_name": "D",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "317-338-7419"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanne Mary Poole, PT
• Randolph Southern School Corporation
• Reid Physician Associates, Inc. (Family & Occupational Medicine of Lynn & Ridgeville)
• St Vincent Randolph Hospital (Family and Occupational Medicine of Lynn)
• St. Vincent Physician Network, LLC
• Alan Leo White, D.D.S.

• Rural Health Clinic/Center in Lynn, IN
• Providers in Lynn, IN by specialty
• Rural Health Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.