NPIMap

Organization Active NPI

Apollo Medical Group LLC

  • Anesthesiology Physician
  • Rockport, IN
National Provider Identifier
1396179461
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
APOLLO MEDICAL GROUP LLC
Practice address
1276 N Plaza Dr
Rockport, IN 47635-9028
Phone
(812) 649-2500
Fax
(941) 358-9818
NPI assigned
Aug 26, 2013
Last updated
Apr 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Authorized official

Name
Robin Van Sprundel
Title
Director of Administration
Phone
(941) 725-1198

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X IN
Anesthesiology Physician 207L00000X IN Primary

Addresses

Primary practice location

1276 N Plaza Dr
Rockport, IN 47635-9028

Mailing address

PO Box 4606
Springfield, IL 62708-4606
Phone (941) 360-1566

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

6094 14th St W
Ste 103
Bradenton, FL 34207

8437 Bell Oaks Dr
Newburgh, IN 47630
Phone (812) 271-0711

Practitioners & affiliated clinicians

Practitioners 45

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.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1377475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680652800000",
    "number": "1396179461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4606",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627084606",
            "telephone_number": "941-360-1566",
            "fax_number": "941-358-9818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 N PLAZA DR",
            "city": "ROCKPORT",
            "state": "IN",
            "postal_code": "476359028",
            "telephone_number": "812-649-2500",
            "fax_number": "941-358-9818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APOLLO MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-26",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A",
        "authorized_official_last_name": "VAN SPRUNDEL",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "DIRECTOR OF ADMINISTRATION",
        "authorized_official_telephone_number": "941-725-1198"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockport, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.