Active NPI
American Health Network of Indiana, LLC
- Hematology & Oncology Physician
- Kokomo, IN
National Provider Identifier
1285831339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- Legal business name
- AMERICAN HEALTH NETWORK OF INDIANA, LLC
- Practice address
- 1907 W Sycamore St
Kokomo, IN 46901-5148 - Phone
- (317) 456-5687
- Fax
- (317) 456-5811
- NPI assigned
- Jul 2, 2007
- Organization subpart
- Yes
- Parent organization
- AMERICAN HEALTH NETWORK OF INDIANA, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ben H Park, MD
- Title
- President and Ceo
- Phone
- (317) 580-6314
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | Primary |
Addresses
Primary practice location
1907 W Sycamore St
Kokomo, IN 46901-5148
Mailing address
6845 Parkdale PL
Suite E
Indianapolis, IN 46254-5618
Phone (317) 295-0260
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| 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
National Provider Directory- Part of
- American Health Network LLC
Locations
6845 Parkdale Pl
Ste E
Indianapolis, IN 46254
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183334400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1199836800000",
"number": "1285831339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6845 PARKDALE PL",
"address_2": "SUITE E",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462545618",
"telephone_number": "317-295-0260",
"fax_number": "317-295-0215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1907 W SYCAMORE ST",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469015148",
"telephone_number": "317-456-5687",
"fax_number": "317-456-5811"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AMERICAN HEALTH NETWORK OF INDIANA, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "AMERICAN HEALTH NETWORK OF INDIANA, LLC",
"enumeration_date": "2007-07-02",
"last_updated": "2008-01-09",
"status": "A",
"authorized_official_last_name": "PARK",
"authorized_official_first_name": "BEN",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "PRESIDENT AND CEO",
"authorized_official_telephone_number": "317-580-6314",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Hematology & Oncology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kokomo, IN
- Adylynn Altman
- Altra Home Health, LLC
- Clarence Bonoan Amayun, M.D.
- Nathan Clarence Amayun
- Amedisys Hospice, 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
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; 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.