Cep America LLC
Organization Active NPI Emergency Medicine Physician · Plymouth, IN
NPI 1336948629 · NPPES record last updated Mar 10, 2025
Key facts
- NPI
- 1336948629
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- CEP AMERICA LLC
- Practice address
- 1915 Lake Ave
Plymouth, IN 46563-9366 - Phone
- (574) 948-4000
- NPI assigned
- Mar 10, 2025
- Organization subpart
- No
Authorized official
- Name
- David Birdsall, MD
- Title
- Coo of Clinical Operations
- Phone
- (510) 350-2600
Other NPIs on the same Medicare enrollment 15
Corporate family (same tax ID) 29
Practitioners 13
-
Jessica Cooper, FNP
-
Amy Marie Fish, NP
-
Bruce D Harley, MD
-
Peter Ray Martin, MD
-
Richard B Shore II, PA-C
-
Mariah Conyers, PA-C
-
Andrea Ellen Lusczakoski, PA-C
-
Floyd Allen Timm, MD
-
Jessica K Walters, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190214000611 | IN | Part B Supplier - Clinic/Group Practice | 6608056171 |
Receives reassigned benefits from 729 practitioners 15 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Plymouth, IN; Indianapolis, IN; Kokomo, IN; Madison, IN; Merrillville, IN; Mishawaka, IN; Munster, IN; New Castle, IN… |
National Provider Directory
- Tax ID family
- Cep America LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes |
Addresses
Primary practice location
1915 Lake Ave
Plymouth, IN 46563-9366
Mailing address
2100 Powell St Ste 400
Emeryville, CA 94608-1872
Phone (510) 851-7501
Other providers in Plymouth, IN
- Carmien & Pedavoli Family Dentistry, LLC
- Matthew Steven Carmien
- Charlie J Celadina II
- Central Indiana Orthopedics, LLC
- Cep America - Anesthesia PC
- Sarah Chambers
- Christopher A Chesnut
- City of Plymouth
- Aimee Clady
- Samantha Clark
All providers in Plymouth, IN · Emergency Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.