NPIMap

Organization Active NPI

St. Vincent Medical Group, Inc.

  • Clinic Pharmacy
  • Elwood, IN
National Provider Identifier
1124459573
Registry record updated Dec 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
Legal business name
ST. VINCENT MEDICAL GROUP, INC.
Practice address
7408 W State Road 28
Suite 1
Elwood, IN 46036-8600
Phone
(765) 557-2240
NPI assigned
Dec 11, 2013
Last updated
Dec 12, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. VINCENT MEDICAL GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 12, 2013

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

Authorized official

Name
Bradley McNabb
Title
Chief Operating Officer
Phone
(317) 583-3078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X IN Primary

Addresses

Primary practice location

7408 W State Road 28
Suite 1
Elwood, IN 46036-8600

Mailing address

10330 N Meridian St
Suite 201
Indianapolis, IN 46290-1024
Phone (317) 583-3078

Other names 1

  • Red Gold Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
St Vincent Medical Group45 organizations share this tax ID, including this one
Part of
St Vincent Medical Group

Other organizations with this tax ID 44

Organizations that report the same tax identification number in the National Provider Directory.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1386720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386806400000",
    "number": "1124459573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10330 N MERIDIAN ST",
            "address_2": "SUITE 201",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462901024",
            "telephone_number": "317-583-3078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7408 W STATE ROAD 28",
            "address_2": "SUITE 1",
            "city": "ELWOOD",
            "state": "IN",
            "postal_code": "460368600",
            "telephone_number": "765-557-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VINCENT MEDICAL GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. VINCENT MEDICAL GROUP, INC.",
        "enumeration_date": "2013-12-11",
        "last_updated": "2013-12-12",
        "status": "A",
        "authorized_official_last_name": "MCNABB",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "317-583-3078"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Gold Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Elwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; 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.