Board of Trustees of Welborn Clinic

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

BOARD OF TRUSTEES OF WELBORN CLINIC

Doing business as

Welborn Clinic IDTF Reo

Practice address

3434 W State Road 66
Rockport, IN 47635-9259

Phone

(812) 649-5061

NPI assigned

Feb 2, 2007

Last updated

Nov 29, 2007By 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

David D Christeson, MD

Title

Ceo

Phone

(812) 426-9228

Specialties & licenses 2

Addresses

Other names 1

• Welborn Clinic IDTF Reo Doing business as

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196294400000",
    "number": "1124166194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 W STATE ROAD 66",
            "city": "ROCKPORT",
            "state": "IN",
            "postal_code": "476359259",
            "telephone_number": "812-649-5061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 W STATE ROAD 66",
            "city": "ROCKPORT",
            "state": "IN",
            "postal_code": "476359259",
            "telephone_number": "812-649-5061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARD OF TRUSTEES OF WELBORN CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-11-29",
        "status": "A",
        "authorized_official_last_name": "CHRISTESON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-426-9228",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Welborn Clinic IDTF Reo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Apollo Medical Group LLC
• Carrie Margaret Arias, M.D.
• John Phillip Atkinson, D.D.S.
• Chrstina M. Beeler, LCSW
• Board of Trustees of Welborn Clinic (Welborn Clinic DME Reo)
• Bolster Wellness LLC
• Arnold H Braun, DDS
• James Michael Braun, RPH
• Kaitlin Brummett, LSW
• Angela D Bunner, FNP

• Diagnostic Radiology Physician in Rockport, IN
• Providers in Rockport, IN by specialty
• Diagnostic Radiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; 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.