Edelbrook Emergency Physicians LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

EDELBROOK EMERGENCY PHYSICIANS LLC

Practice address

3901 S 7TH St
Terre Haute, IN 47802-5709

Phone

(469) 401-2386

NPI assigned

Jan 12, 2017

Organization subpart

No

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

Authorized official

Name

Kathleen Kondas

Title

Officer

Phone

(973) 251-1132

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635724800000",
    "number": "1366988479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80164",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191011164",
            "telephone_number": "954-838-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 S 7TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478025709",
            "telephone_number": "469-401-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDELBROOK EMERGENCY PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-12",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A",
        "authorized_official_last_name": "KONDAS",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "973-251-1132"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emergency Medicine Physician in Terre Haute, IN
• Providers in Terre Haute, IN by specialty
• Emergency Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.