Integrated Body and Medicine, PC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

INTEGRATED BODY AND MEDICINE, PC

Practice address

8145 Kennedy Ave
Highland, IN 46322-1128

Phone

(219) 803-6630

Fax

(219) 937-7237

NPI assigned

Aug 30, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Ahmad Sprouse, DCNPI 1205293800

Title

Owner

Phone

(219) 803-6630

Specialties & licenses 1

Addresses

Other names 1

• Kennedy Ave Chiropractic Other name

Medicare fee-for-service enrollment

Enrolled in IN2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ahmad Sprouse, DC

  • Chiropractor
  • Highland, IN
  • NPI 1205293800
  Medicare reassignment Care Compare group NPD Authorized official
• Akshata Torgal, D.P.T.

  • Physical Therapist
  • Hammond, IN
  • NPI 1942456678
  Medicare reassignment Care Compare group NPD
• Shondra Godlock, FNP

  • Family Nurse Practitioner
  • Munster, IN
  • NPI 1801612411
  Medicare reassignment Care Compare group
• Nicole Renee Fornari, FNP-C

  • Family Nurse Practitioner
  • Valparaiso, IN
  • NPI 1265997332
  Medicare reassignment NPD
• Andrea Zepeda, MSN FNP-BC

  • Nurse Practitioner
  • Highland, IN
  • NPI 1881388205
  Medicare reassignment NPD
• Maureen Salinas

  • Family Nurse Practitioner
  • Schererville, IN
  • NPI 1700306057
  NPD

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646092800000",
    "number": "1407404569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8145 KENNEDY AVE",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463221128",
            "telephone_number": "219-803-6630",
            "fax_number": "219-937-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8145 KENNEDY AVE",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463221128",
            "telephone_number": "219-803-6630",
            "fax_number": "219-937-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED BODY AND MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-30",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A",
        "authorized_official_last_name": "SPROUSE",
        "authorized_official_first_name": "AHMAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-803-6630",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kennedy Ave Chiropractic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Kennedy Ave Chiropractic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• General Practice Physician in Highland, IN
• Providers in Highland, IN by specialty
• General Practice Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.