Jackson Park Physicians, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

50000714A Issued in IN

Legal business name

JACKSON PARK PHYSICIANS, PC

Practice address

1124 Medical Place
Seymour, IN 47274

Phone

(812) 522-1613

Fax

(812) 522-6694

NPI assigned

Feb 1, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Kelley M Gillaspy

Title

Practice Manager

Phone

(812) 522-1613

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Robert Baker, MD

  • Family Medicine Physician
  • Seymour, IN
  • NPI 1093779316
  NPD
• Michael W Conway, MD

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1134184781
  NPD

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372118400000",
    "number": "1346388576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 MEDICAL PLACE",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "47274",
            "telephone_number": "812-522-1613",
            "fax_number": "812-522-6694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 MEDICAL PLACE",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "47274",
            "telephone_number": "812-522-1613",
            "fax_number": "812-522-6694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON PARK PHYSICIANS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2013-06-25",
        "status": "A",
        "authorized_official_last_name": "GILLASPY",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "812-522-1613",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "50000714A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100141330",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackson County Schneck Memorial Hospital
• Jackson County Schneck Memorial Hospital
• Jackson County Schneck Memorial Hospital
• Jackson County Schneck Memorial Hospital
• Jackson County Schneck Memorial Hospital
• Amy Elizabeth Jackson, PA C
• Elizabeth Anne Jackson, FNP
• Michael L Jackson, MD
• Jeffrey E. Schulz, M.D, P.C.
• Makayla Jessie

• Family Medicine Physician in Seymour, IN
• Providers in Seymour, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; 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.