Organization Active NPI

Warsaw Health System LLC

  • Family Medicine Physician
  • Warsaw, IN
National Provider Identifier
1205948486
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WARSAW HEALTH SYSTEM LLC
Practice address
1210 Provident Dr
Suite B
Warsaw, IN 46580-3266
Phone
(574) 372-5823
NPI assigned
Aug 31, 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
Rebecca Hurley
Title
Senior Vice President
Phone
(214) 473-3993

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1210 Provident Dr
Suite B
Warsaw, IN 46580-3266

Mailing address

PO Box 996
Warsaw, IN 46581-0996
Phone (574) 372-5823

Other names 1

  • Provident Family Healthcare Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205948486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 996",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465810996",
            "telephone_number": "574-372-5823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 PROVIDENT DR",
            "address_2": "SUITE B",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803266",
            "telephone_number": "574-372-5823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARSAW HEALTH SYSTEM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HURLEY",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "214-473-3993"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Provident Family Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warsaw, 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.