NPIMap

Individual provider Active NPI

Jonathan D Hart, M.D.

  • Family Medicine Physician
  • Bloomington, IN
National Provider Identifier
1154300770
Registry record updated Sep 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01039715A Issued in IN
Practice address
2605 E Creeks Edge Dr
Bloomington, IN 47401-8368
Phone
(812) 355-2300
Fax
(812) 355-2316
NPI assigned
Jan 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01039715 IN
Family Medicine Physician 207Q00000X 01039715A IN Primary
Hospitalist Physician 208M00000X 01039715A IN

Addresses

Primary practice location

2605 E Creeks Edge Dr
Bloomington, IN 47401-8368

Mailing address

2605 E Creeks Edge Dr
Bloomington, IN 47401-8368
Phone (812) 355-2300

Other identifiers 1

IdentifierTypeStateIssuer
200008900MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01039715INMDEmergency Medicine Physician
01039715AINMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monroe Physicians Group Emergency Medicine Past Accepting new patients
Bloomington Emergency Group PC Emergency Medicine Past Accepting new patients
Midwest Medical Management, P.C. Emergency Medicine Past Accepting new patients
Indiana University Health Paoli Inc Past Accepting new patients
Monroe Hospital Ambulance Service PastSince Oct 1, 2008 Accepting new patients
Monroe Physicians Group Past Accepting new patients
Anesthesia Care of Bloomington PC Past Accepting new patients
Emergency Medicine Professionals of Indiana LLC Emergency Medicine Past Accepting new patients
Midwest Medical Management, P.C. Emergency Medicine Past Accepting new patients

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1154300770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 E CREEKS EDGE DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474018368",
            "telephone_number": "812-355-2300",
            "fax_number": "812-355-2316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 E CREEKS EDGE DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474018368",
            "telephone_number": "812-355-2300",
            "fax_number": "812-355-2316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "JONATHAN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01039715",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01039715A",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01039715A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200008900",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; 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.