Active NPI
American Health Network of Indiana, LLC
- Neurology with Special Qualifications in Child Neurology Physician
- Indianapolis, IN
National Provider Identifier
1376668780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology with Special Qualifications in Child Neurology Physician
- Legal business name
- AMERICAN HEALTH NETWORK OF INDIANA, LLC
- Practice address
- 6820 Parkdale PL
Suite 105
Indianapolis, IN 46254-6601 - Phone
- (317) 328-6730
- Fax
- (317) 388-8457
- NPI assigned
- Mar 21, 2007
- Organization subpart
- Yes
- Parent organization
- AMERICAN HEALTH NETWORK OF INDIANA, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ben H Park, MD
- Title
- President and Ceo
- Phone
- (317) 580-6314
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology with Special Qualifications in Child Neurology Physician | 2084N0402X | Primary | ||
| Pain Medicine (Psychiatry & Neurology) Physician | 2084P2900X |
Addresses
Primary practice location
6820 Parkdale PL
Suite 105
Indianapolis, IN 46254-6601
Mailing address
4850 Century Plaza Rd
Suite 180
Indianapolis, IN 46254-5476
Phone (317) 328-6730
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031124000691 | IN | Part B Supplier - Clinic/Group Practice | 9830093533 |
Receives reassigned benefits from 230 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider Directory- Part of
- American Health Network LLC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1199750400000",
"number": "1376668780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4850 CENTURY PLAZA RD",
"address_2": "SUITE 180",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462545476",
"telephone_number": "317-328-6730",
"fax_number": "317-388-8457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6820 PARKDALE PL",
"address_2": "SUITE 105",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462546601",
"telephone_number": "317-328-6730",
"fax_number": "317-388-8457"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AMERICAN HEALTH NETWORK OF INDIANA, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "AMERICAN HEALTH NETWORK OF INDIANA, LLC",
"enumeration_date": "2007-03-21",
"last_updated": "2008-01-08",
"status": "A",
"authorized_official_last_name": "PARK",
"authorized_official_first_name": "BEN",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "PRESIDENT AND CEO",
"authorized_official_telephone_number": "317-580-6314",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2084N0402X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
"state": null,
"license": null,
"primary": true
},
{
"code": "2084P2900X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Pain Medicine",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
- American Health Network of Indiana, LLC
- American Health Network of Indiana, LLC
- American Health Network of Indiana, LLC
- American Health Network of Indiana, LLC
- American Health Network of Indiana, LLC
- American Health Network of Indiana, LLC
- American Health Network of Indiana, LLC
- American Health Network of Indiana, LLC
- American Health Network of Indiana, LLC
- American Health Network of Indiana, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; 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.