NPIMap

Organization Active NPI

Vituity - Indiana Critical Care PC

  • Critical Care Medicine (Internal Medicine) Physician
  • Terre Haute, IN
National Provider Identifier
1356922397
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
Legal business name
VITUITY - INDIANA CRITICAL CARE PC
Practice address
1606 N 7TH St
Terre Haute, IN 47804-2706
Phone
(812) 238-7000
NPI assigned
Apr 20, 2021
Last updated
Jul 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Authorized official

Name
Theophile Koury, MDNPI 1568483691
Title
President
Phone
(510) 350-2600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X Primary

Addresses

Primary practice location

1606 N 7TH St
Terre Haute, IN 47804-2706

Mailing address

2100 Powell St Ste 400
Emeryville, CA 94608-1826
Phone (510) 350-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210707003280 IN Part B Supplier - Clinic/Group Practice 2163824558 Receives reassigned benefits from 6 practitioners
Practice locations: Terre Haute, IN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1618876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721347200000",
    "number": "1356922397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST STE 400",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 N 7TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478042706",
            "telephone_number": "812-238-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITUITY - INDIANA CRITICAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-20",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A",
        "authorized_official_last_name": "KOURY",
        "authorized_official_first_name": "THEOPHILE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-350-2600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.