NPIMap

Organization Active NPI

Genesis Eldercare Physicians Services LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • New Haven, IN
National Provider Identifier
1346623386
Registry record updated Apr 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
GENESIS ELDERCARE PHYSICIANS SERVICES LLC
Practice address
1201 Daly Dr
New Haven, IN 46774-1891
Phone
(260) 749-0413
NPI assigned
Jul 8, 2015
Last updated
Apr 13, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2018

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

Authorized official

Name
Mr. Eric Shapiro
Title
VP/Area Controller
Phone
(410) 832-7790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X Primary

Addresses

Primary practice location

1201 Daly Dr
New Haven, IN 46774-1891

Mailing address

PO Box 42738
Towson, MD 21284-2738
Phone (410) 832-7790

National Provider Directory

National Provider Directory
Tax ID family
Genesis Physician Servi9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523577600000",
    "number": "1346623386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42738",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212842738",
            "telephone_number": "410-832-7790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 DALY DR",
            "city": "NEW HAVEN",
            "state": "IN",
            "postal_code": "467741891",
            "telephone_number": "260-749-0413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS ELDERCARE PHYSICIANS SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-08",
        "last_updated": "2018-04-13",
        "status": "A",
        "authorized_official_last_name": "SHAPIRO",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "VP/AREA CONTROLLER",
        "authorized_official_telephone_number": "410-832-7790",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; 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.