Organization Active NPI

Concierge Care of Southern Indiana LLC

  • General Practice Physician
  • Floyds Knobs, IN
National Provider Identifier
1245990449
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
CONCIERGE CARE OF SOUTHERN INDIANA LLC
Practice address
500 Lafollette Sta S
Floyds Knobs, IN 47119-8747
Phone
(812) 596-9362
NPI assigned
Dec 29, 2021
Last updated
Mar 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Authorized official

Name
Daniel Eichenberger, MDNPI 1255316527
Title
Owner
Phone
(812) 596-9362

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

500 Lafollette Sta S
Floyds Knobs, IN 47119-8747

Mailing address

500 Lafollette Sta N
Floyds Knobs, IN 47119-8747
Phone (812) 596-9362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220317000571 IN Part B Supplier - Clinic/Group Practice 1850786427 Receives reassigned benefits from 3 practitioners
Practice locations: Floyds Knobs, IN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2248665Concierge Care of Southern Indiana500 Lafollette Station Dr, Suite a, Floyds Knobs, IN 47119Certificate of waiverJan 13, 2028

National Provider Directory

National Provider Directory

Locations

500 Lafollette Sta N
Floyds Knobs, IN 47119

500 Lafollette Sta N
Ste A
Floyds Knobs, IN 47119
Phone (812) 596-9362

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1640736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1245990449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LAFOLLETTE STA N",
            "city": "FLOYDS KNOBS",
            "state": "IN",
            "postal_code": "471198747",
            "telephone_number": "812-596-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LAFOLLETTE STA S",
            "city": "FLOYDS KNOBS",
            "state": "IN",
            "postal_code": "471198747",
            "telephone_number": "812-596-9362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCIERGE CARE OF SOUTHERN INDIANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-29",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A",
        "authorized_official_last_name": "EICHENBERGER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-596-9362",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Floyds Knobs, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.