NPIMap

Organization Active NPI

Indiana Physician Services LLC

  • Emergency Medicine Physician
  • Valparaiso, IN
National Provider Identifier
1184860512
Registry record updated Mar 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
INDIANA PHYSICIAN SERVICES LLC
Practice address
85 E US Highway 6
Valparaiso, IN 46383-8947
Phone
(219) 983-8300
NPI assigned
Jan 7, 2009
Last updated
Mar 3, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2017

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

Authorized official

Name
Mr. Christopher Brian Durham
Title
President
Phone
(770) 874-5400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

85 E US Highway 6
Valparaiso, IN 46383-8947

Mailing address

5665 New Northside Dr NW
Suite 320
Atlanta, GA 30328-5831
Phone (770) 784-5408

National Provider Directory

National Provider Directory

Locations

814 Laporte Ave
Valparaiso, IN 46383
Phone (219) 263-4600

Practitioners & affiliated clinicians

Practitioners 30

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.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488499200000",
    "number": "1184860512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5665 NEW NORTHSIDE DR NW",
            "address_2": "SUITE 320",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285831",
            "telephone_number": "770-784-5408",
            "fax_number": "770-784-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 E US HIGHWAY 6",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463838947",
            "telephone_number": "219-983-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA PHYSICIAN SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-07",
        "last_updated": "2017-03-03",
        "status": "A",
        "authorized_official_last_name": "DURHAM",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-874-5400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2017; 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.