American Health Network of Indiana, LLC
Organization Active NPI Family Medicine Physician · Avon, IN
NPI 1245334259 · NPPES record last updated Jan 8, 2008
Key facts
- NPI
- 1245334259
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- AMERICAN HEALTH NETWORK OF INDIANA, LLC
- Practice address
- 1115 Ronald Reagan Pkwy
Suite 100
Avon, IN 46123-6910 - Phone
- (317) 272-7013
- Fax
- (317) 272-7007
- NPI assigned
- Sep 11, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- AMERICAN HEALTH NETWORK OF INDIANA, LLC
Authorized official
- Name
- Ben H Park, MD
- Title
- President and Ceo
- Phone
- (317) 580-6307
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031124000691 | IN | Part B Supplier - Clinic/Group Practice | 9830093533 |
Receives reassigned benefits from 230 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Part of
- American Health Network LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Internal Medicine Physician |
207R00000X | |||
| Hematology & Oncology Physician |
207RH0003X | |||
| Obstetrics & Gynecology Physician |
207V00000X | |||
| Orthopaedic Surgery Physician |
207X00000X | |||
| Physical Medicine & Rehabilitation Physician |
208100000X | |||
| Neurology Physician |
2084N0400X | |||
| Pain Medicine (Psychiatry & Neurology) Physician |
2084P2900X | |||
| Nuclear Radiology Physician |
2085N0904X | |||
| Diagnostic Radiology Physician |
2085R0202X | |||
| Diagnostic Ultrasound Physician |
2085U0001X | |||
| Surgery Physician |
208600000X | |||
| Pain Medicine Physician |
208VP0000X | |||
| Interventional Pain Medicine Physician |
208VP0014X |
Addresses
Primary practice location
1115 Ronald Reagan Pkwy
Suite 100
Avon, IN 46123-6910
Mailing address
4850 Century Plaza Rd
Suite 180
Indianapolis, IN 46254-5476
Phone (317) 272-7013
Other providers in Avon, IN
- Alternative to Crutches
- Jennifer K Amador
- Amberrdrx
- American Health Network of Indiana, LLC
- American Health Network of Indiana, LLC
- American Health Network of Indiana, LLC
- American Health Network of Indiana, LLC
- American Health Network of Indiana, LLC
- American Health Network of Indiana, LLC
- American Health Network of Indiana, LLC
All providers in Avon, IN · Family Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.