Organization Active NPI

Terrehaute Internal Medicine LLC

  • Internal Medicine Physician
  • Terre Haute, IN
National Provider Identifier
1275645228
Registry record updated Aug 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
TERREHAUTE INTERNAL MEDICINE LLC
Practice address
420 E Hospital LN
Terre Haute, IN 47802-4251
Phone
(812) 238-0958
Fax
(812) 238-0960
NPI assigned
Aug 31, 2006
Last updated
Aug 22, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2014

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

Authorized official

Name
Dr. Pardeep Kumar, MDNPI 1336251354
Title
Managing Member
Phone
(812) 238-0958

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

420 E Hospital LN
Terre Haute, IN 47802-4251

Mailing address

420 E Hospital LN
Terre Haute, IN 47802-4251
Phone (812) 238-0958

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041019001160 IN Part B Supplier - Clinic/Group Practice 3173584646 Receives reassigned benefits from 2 practitioners
Practice locations: Terre Haute, IN

National Provider Directory

National Provider Directory

Locations

420 E Hospital Ln
Terre Haute, IN 47802
Phone (812) 235-3658

Practitioners & affiliated clinicians

Practitioners 2

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408665600000",
    "number": "1275645228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E HOSPITAL LN",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478024251",
            "telephone_number": "812-238-0958",
            "fax_number": "812-238-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E HOSPITAL LN",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478024251",
            "telephone_number": "812-238-0958",
            "fax_number": "812-238-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERREHAUTE INTERNAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-08-22",
        "status": "A",
        "authorized_official_last_name": "KUMAR",
        "authorized_official_first_name": "PARDEEP",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "812-238-0958",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2014; 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.