Organization Active NPI

Eastern Indiana Center for Ambulatory Surgery LLC

  • Ambulatory Surgical Clinic/Center
  • Richmond, IN
National Provider Identifier
1205801461
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
EASTERN INDIANA CENTER FOR AMBULATORY SURGERY LLC
Practice address
1350 Chester Blvd
Richmond, IN 47374-1907
Phone
(765) 939-1351
NPI assigned
Feb 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Joseph M Smith, M.D.
Title
Medical Director
Phone
(765) 939-1351

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X IN Primary

Addresses

Primary practice location

1350 Chester Blvd
Richmond, IN 47374-1907

Mailing address

1350 Chester Blvd
Richmond, IN 47374-1907
Phone (765) 939-1351

Other identifiers 2

IdentifierTypeStateIssuer
000000098211OtherINANTHEM PROVIDER NUMBER
2069532MedicaidOH

National Provider Directory

National Provider Directory

Locations

1350 Chester Blvd
Ste 2A
Richmond, IN 47374
Phone (765) 939-3278

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205801461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 CHESTER BLVD",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741907",
            "telephone_number": "765-939-1351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 CHESTER BLVD",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741907",
            "telephone_number": "765-939-1351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN INDIANA CENTER FOR AMBULATORY SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "765-939-1351",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000098211",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2069532",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.