NPIMap

Open Door Health Services

Organization Active NPI Federally Qualified Health Center (FQHC) · Marion, IN

NPI 1376865733 · NPPES record last updated Jan 31, 2012

Key facts

NPI
1376865733
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
OPEN DOOR HEALTH SERVICES
Practice address
319 E 2ND St
Marion, IN 46952-3871
Phone
(765) 574-4971
Fax
(765) 573-4973
NPI assigned
Feb 25, 2010
Organization subpart
Yes
Parent organization (as reported)
OPEN DOOR HEALTH SERVICES

Authorized official

Name
Toni R Estep
Title
Ceo
Phone
(765) 747-2971

Corporate family (same tax ID) 8

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

National Provider Directory

Tax ID family
Open Door BMH Health Center (9 organizations share this tax ID)
Part of
Open Door BMH Health Center

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Surgical Family Planning Clinic/Center 261QF0050X
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

319 E 2ND St
Marion, IN 46952-3871

Mailing address

PO Box 1676
Muncie, IN 47308-1676
Phone (765) 286-7000

Other identifiers

IdentifierTypeStateIssuer
200167970GMedicaidIN

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 31, 2012.

{
    "created_epoch": "1267056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327968000000",
    "number": "1376865733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1676",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473081676",
            "telephone_number": "765-286-7000",
            "fax_number": "765-213-2769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 E 2ND ST",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469523871",
            "telephone_number": "765-574-4971",
            "fax_number": "765-573-4973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN DOOR HEALTH SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OPEN DOOR HEALTH SERVICES",
        "enumeration_date": "2010-02-25",
        "last_updated": "2012-01-31",
        "status": "A",
        "authorized_official_last_name": "ESTEP",
        "authorized_official_first_name": "TONI",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "765-747-2971"
    },
    "taxonomies": [
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200167970G",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IN

All providers in Marion, IN · Federally Qualified Health Center (FQHC) in Indiana

Sources for this page

Verify at the official NPI Registry.