Organization Active NPI

Union Associated Physicians Clinic, LLC

  • Medical Oncology Physician
  • Sullivan, IN
National Provider Identifier
1316270747
Registry record updated Aug 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
Legal business name
UNION ASSOCIATED PHYSICIANS CLINIC, LLC
Practice address
2229 Mary Sherman Dr
Sullivan, IN 47882-7633
Phone
(812) 269-3318
NPI assigned
Sep 17, 2009
Organization subpart
Yes
Parent organization
UNION ASSOCIATED PHYSICIANS CLINIC, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 12, 2010

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

Authorized official

Name
Michael P Fouty
Title
Cfo
Phone
(812) 232-0564

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RX0202X Primary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X

Addresses

Primary practice location

2229 Mary Sherman Dr
Sullivan, IN 47882-7633

Mailing address

221 S 6TH St
Terre Haute, IN 47807-4214
Phone (812) 232-0564

Other identifiers 2

IdentifierTypeStateIssuer
200975660MedicaidIN
DQ0893OtherINRAILROAD MEDICARE

National Provider Directory

National Provider Directory
Part of
Union Associated Physicians

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

75 Remittance Dr
Dept 6219
Chicago, IL 60675

NPI Registry JSON

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

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281571200000",
    "number": "1316270747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 S 6TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478074214",
            "telephone_number": "812-232-0564",
            "fax_number": "812-242-3861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2229 MARY SHERMAN DR",
            "city": "SULLIVAN",
            "state": "IN",
            "postal_code": "478827633",
            "telephone_number": "812-269-3318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNION ASSOCIATED PHYSICIANS CLINIC, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNION ASSOCIATED PHYSICIANS CLINIC, LLC",
        "enumeration_date": "2009-09-17",
        "last_updated": "2010-08-12",
        "status": "A",
        "authorized_official_last_name": "FOUTY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "812-232-0564"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200975660",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DQ0893",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sullivan, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; 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.