NPIMap

Organization Active NPI

Connersville OBGYN Inc

  • Gynecology Physician
  • Connersville, IN
National Provider Identifier
1225182272
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
01045645 Issued in IN
Legal business name
CONNERSVILLE OBGYN INC
Practice address
1619 N Grand Ave
Connersville, IN 47331-2230
Phone
(765) 825-0811
Fax
(765) 827-5278
NPI assigned
Jan 23, 2007
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. Vance Andre' Raham, MD
Title
President
Phone
(765) 825-0811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X 01045645 IN Primary

Addresses

Primary practice location

1619 N Grand Ave
Connersville, IN 47331-2230

Mailing address

1619 N Grand Ave
Connersville, IN 47331-2230
Phone (765) 825-0811

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225182272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 N GRAND AVE",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473312230",
            "telephone_number": "765-825-0811",
            "fax_number": "765-827-5278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 N GRAND AVE",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473312230",
            "telephone_number": "765-825-0811",
            "fax_number": "765-827-5278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNERSVILLE OBGYN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RAHAM",
        "authorized_official_first_name": "VANCE",
        "authorized_official_middle_name": "ANDRE'",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "765-825-0811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "IN",
            "license": "01045645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Connersville, 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.