NPIMap

Organization Active NPI

Indiana University Health Southern Indiana Physicians, Inc

  • Rural Health Clinic/Center
  • Spencer, IN
National Provider Identifier
1366600231
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
INDIANA UNIVERSITY HEALTH SOUTHERN INDIANA PHYSICIANS, INC
Practice address
9 N Crane Ave
Spencer, IN 47460-1507
Phone
(812) 829-2237
Fax
(812) 829-6342
NPI assigned
May 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Authorized official

Name
Marlon B Fishel
Title
Administration, Iu Health Sip
Phone
(812) 353-5866

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

9 N Crane Ave
Spencer, IN 47460-1507

Mailing address

PO Box 1329
Bloomington, IN 47402-1329
Phone (812) 829-2237

Other identifiers 2

IdentifierTypeStateIssuer
200133950AMedicaidIN
CI4187OtherINRAILROAD MEDICARE

Other names 1

  • Hometown Healthcare Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040423000556 IN Part B Supplier - Clinic/Group Practice 6204748197 Receives reassigned benefits from 878 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bloomington, IN; Mitchell, IN; French Lick, IN; Gosport, IN; Indianapolis, IN; Linton, IN; Martinsville, IN; Nashville, IN…

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 4

Organizations this organization is a member of, according to the National Provider Directory.

Locations

9 N Crane Ave
Spencer, IN 47460
Phone (812) 829-2237

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645488000000",
    "number": "1366600231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1329",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474021329",
            "telephone_number": "812-829-2237",
            "fax_number": "812-829-6342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 N CRANE AVE",
            "city": "SPENCER",
            "state": "IN",
            "postal_code": "474601507",
            "telephone_number": "812-829-2237",
            "fax_number": "812-829-6342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA UNIVERSITY HEALTH SOUTHERN INDIANA PHYSICIANS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-28",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A",
        "authorized_official_last_name": "FISHEL",
        "authorized_official_first_name": "MARLON",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "ADMINISTRATION, IU HEALTH SIP",
        "authorized_official_telephone_number": "812-353-5866"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200133950A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI4187",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hometown Healthcare",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Hometown Healthcare",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Spencer, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; 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.