Obaseki Indiana Family Health Clinic, Prof. Corp.

Primary specialty

Family Health Clinical Nurse SpecialistTaxonomy code 364SF0001X

License

71000903A Issued in IN

Legal business name

OBASEKI INDIANA FAMILY HEALTH CLINIC, PROF. CORP.

Practice address

645 Canal St
Evansville, IN 47713-2441

Phone

(812) 491-8765

Fax

(812) 491-8766

NPI assigned

Jan 29, 2013

Organization subpart

No

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

Authorized official

Name

Art O Obaseki, NP

Title

President

Phone

(812) 491-8765

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1359417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359417600000",
    "number": "1346588134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 CANAL ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477132441",
            "telephone_number": "812-491-8765",
            "fax_number": "812-491-8766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 CANAL ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477132441",
            "telephone_number": "812-491-8765",
            "fax_number": "812-491-8766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBASEKI INDIANA FAMILY HEALTH CLINIC, PROF. CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-29",
        "last_updated": "2013-01-29",
        "status": "A",
        "authorized_official_last_name": "OBASEKI",
        "authorized_official_first_name": "ART",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-491-8765",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IN",
            "license": "01039780A",
            "primary": false
        },
        {
            "code": "364SF0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "IN",
            "license": "71000903A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000354966",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200512070",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Health Clinical Nurse Specialist in Evansville, IN
• Providers in Evansville, IN by specialty
• Family Health Clinical Nurse Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.