Indiana Specialty Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

INDIANA SPECIALTY SURGERY CENTER, LLC

Doing business as

Indiana Specialty Surgery Center

Practice address

1380 W Arch Haven Ave
Bloomington, IN 47403-2055

Phone

(812) 330-1164

Fax

(812) 332-5102

NPI assigned

Nov 7, 2008

Last updated

Nov 7, 2008By 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

Dr. Gregory M Fox, M.D.NPI 1740331263

Title

Ceo

Phone

(812) 333-4000

Specialties & licenses 1

Addresses

Other names 1

• Indiana Specialty Surgery Center Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gregory M Fox, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Bloomington, IN
  • NPI 1740331263
  NPD (past) Authorized official

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

{
    "created_epoch": "1226016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226016000000",
    "number": "1174777817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 W ARCH HAVEN AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032055",
            "telephone_number": "812-330-1164",
            "fax_number": "812-332-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 W ARCH HAVEN AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032055",
            "telephone_number": "812-330-1164",
            "fax_number": "812-332-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA SPECIALTY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-07",
        "last_updated": "2008-11-07",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-333-4000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Indiana Specialty Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Indiana Evaluation Services
• Indiana Hearing LLC (Miracle Ear)
• Indiana Home Health Care Corp.
• Indiana MRI, LLC
• Indiana Safety Professionals (Assisted Medical Transport Services)
• Indiana Spine and Sports Inc.
• Indiana Telepsych NP, LLC
• Indiana University (Atwater Eye Care Center)
• Indiana University
• Indiana University (Community Eye Care Center)

• Ambulatory Surgical Clinic/Center in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Ambulatory Surgical Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2008; 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.