Indiana University Health Ball Memorial Physicians, Inc.
Organization Active NPI Pediatrics Physician · Muncie, IN
NPI 1124348032 · NPPES record last updated Oct 23, 2013
Key facts
- NPI
- 1124348032
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- Legal business name
- INDIANA UNIVERSITY HEALTH BALL MEMORIAL PHYSICIANS, INC.
- Practice address
- 205 N Tillotson Ave
Muncie, IN 47304-3900 - Phone
- (765) 281-4599
- Fax
- (765) 281-9114
- NPI assigned
- Jun 3, 2010
- Organization subpart
- No
Authorized official
- Name
- Janet L Vangets
- Title
- Director/Officer
- Phone
- (765) 751-3311
Other NPIs on the same Medicare enrollment 16
Corporate family (same tax ID) 15
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031110000505 | IN | Part B Supplier - Clinic/Group Practice | 9537072640 |
Receives reassigned benefits from 661 practitioners 17 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Southway Health and Dia
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | Yes |
Addresses
Primary practice location
205 N Tillotson Ave
Muncie, IN 47304-3900
Mailing address
250 N Shadeland Ave
Attn: Carol Boyd
Indianapolis, IN 46219-4959
Phone (317) 963-0413
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200986050 I | Medicaid | IN |
Other names
- IU Health Ball Memorial Physicians
Other providers in Muncie, IN
- Indiana University Health Ball Memorial Physicians Inc
- Indiana University Health Ball Memorial Physicians, Inc
- Indiana University Health Ball Memorial Physicians, Inc
- Indiana University Health Ball Memorial Physicians, Inc.
- Indiana University Health Ball Memorial Physicians, Inc.
- Indiana University Health Ball Memorial Physicians, Inc.
- Indiana University Health Ball Memorial Physicians, Inc.
- Indiana University Health Ball Memorial Physicians, Inc.
- Indiana University Health Ball Memorial Physicians, Inc.
- Indiana University Health Ball Memorial Physicians, Inc.
All providers in Muncie, IN · Pediatrics Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.