Neurosurgical Clinic of Bloomington Inc P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

01040149 Issued in IN

Legal business name

NEUROSURGICAL CLINIC OF BLOOMINGTON INC P.C.

Practice address

700 S College Ave
Suite a
Bloomington, IN 47403-2500

Phone

(812) 331-8168

Fax

(812) 331-1096

NPI assigned

Sep 20, 2005

Organization subpart

No

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

Authorized official

Name

Marshall M. Poor, M.D.

Title

President

Phone

(812) 331-8168

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Souheil F. Haddad, M.D.

  • Specialist
  • Bloomington, IN
  • NPI 1659355931
  Medicare reassignment NPD
• Zachary Hevron Dodd, M.D.

  • Neurological Surgery Physician
  • New Orleans, LA
  • NPI 1538327010
  NPD (past)

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789516800000",
    "number": "1205821899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S COLLEGE AVE STE A",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032512",
            "telephone_number": "812-331-8168",
            "fax_number": "812-331-1096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S COLLEGE AVE",
            "address_2": "SUITE A",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032500",
            "telephone_number": "812-331-8168",
            "fax_number": "812-331-1096"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "815 W 2nd St",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474032212",
            "country_code": "US",
            "telephone_number": "812-331-8168",
            "fax_number": "812-331-1096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEUROSURGICAL CLINIC OF BLOOMINGTON INC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-20",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A",
        "authorized_official_last_name": "POOR",
        "authorized_official_first_name": "MARSHALL",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-331-8168",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "IN",
            "license": "01039391",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "IN",
            "license": "01040149",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "IN",
            "license": "01051484",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Nelson
• Stephen Nering, LMT
• Shashanka Nethi, M.B.B.S.
• Skyler Neuhaus, LSW
• Neurology Specialists, PC
• Jessica Nevitt, M.S., CHES
• New Beacon Hospice Indiana, LLC (New Beacon Bloomington)
• New Outlook Counseling Center Inc
• New Outlook Counseling Center Inc
• Ellyn New

• Specialist in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; 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.