NPIMap

Organization Active NPI

Indiana University Health Ball Memorial Physicians, Inc.

Doing business as IU Health Ball Memorial Physicians

  • Clinic/Center
  • Muncie, IN
National Provider Identifier
1174855696
Registry record updated Oct 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
INDIANA UNIVERSITY HEALTH BALL MEMORIAL PHYSICIANS, INC.
Doing business as
IU Health Ball Memorial Physicians
Practice address
2901 W Jackson St
Muncie, IN 47304-4307
Phone
(765) 751-2765
Fax
(765) 751-5059
NPI assigned
Feb 9, 2010
Last updated
Oct 15, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2013

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

Authorized official

Name
Mr. Michael E. Haley
Title
President and Ceo
Phone
(765) 747-3251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

2901 W Jackson St
Muncie, IN 47304-4307

Mailing address

250 N Shadeland Ave
Attn: Carol Boyd
Indianapolis, IN 46219-4959
Phone (317) 963-0413

Other identifiers 2

IdentifierTypeStateIssuer
RR CA1092OtherINRR MEDICARE
200452010AMedicaidIN

Other names 1

  • IU Health Ball Memorial Physicians Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Indiana University Phy Inc16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1265673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381795200000",
    "number": "1174855696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "address_2": "ATTN: CAROL BOYD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959",
            "telephone_number": "317-963-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 W JACKSON ST",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473044307",
            "telephone_number": "765-751-2765",
            "fax_number": "765-751-5059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA UNIVERSITY HEALTH BALL MEMORIAL PHYSICIANS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-09",
        "last_updated": "2013-10-15",
        "status": "A",
        "authorized_official_last_name": "HALEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "765-747-3251",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "RR CA1092",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200452010A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IU Health Ball Memorial Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.