Organization Active NPI

Community Hospitals of Indiana Inc

Doing business as Southside Adult Medicine

  • Internal Medicine Physician
  • Greenwood, IN
National Provider Identifier
1326091836
Registry record updated Nov 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
COMMUNITY HOSPITALS OF INDIANA INC
Doing business as
Southside Adult Medicine
Practice address
45 N Madison Ave
Greenwood, IN 46142-3526
Phone
(317) 887-7624
Fax
(317) 887-7625
NPI assigned
May 18, 2006
Last updated
Nov 2, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2009

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

Authorized official

Name
Jeffery Kirkham
Title
Cfo
Phone
(317) 355-5822

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

45 N Madison Ave
Greenwood, IN 46142-3526

Mailing address

45 N Madison Ave
Greenwood, IN 46142-3526
Phone (317) 887-7624

Other identifiers 1

IdentifierTypeStateIssuer
200889990AMedicaidIN

Other names 1

  • Southside Adult Medicine Doing business as

National Provider Directory

National Provider Directory

Member of 1

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

Locations

360 S Madison Ave
Ste 200
Greenwood, IN 46142
Phone (317) 865-9090

45 N Madison Ave
Greenwood, IN 46142
Phone (317) 887-7624

1250 E County Line Rd
Ste 9
Indianapolis, IN 46227
Phone (317) 859-5954

Practitioners & affiliated clinicians

Practitioners 1

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": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257120000000",
    "number": "1326091836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 N MADISON AVE",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461423526",
            "telephone_number": "317-887-7624",
            "fax_number": "317-887-7625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 N MADISON AVE",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461423526",
            "telephone_number": "317-887-7624",
            "fax_number": "317-887-7625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HOSPITALS OF INDIANA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2009-11-02",
        "status": "A",
        "authorized_official_last_name": "KIRKHAM",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "317-355-5822"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200889990A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southside Adult Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2009; 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.