Physician Practice Organization

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

207Q00000X Issued in IN

Legal business name

PHYSICIAN PRACTICE ORGANIZATION

Doing business as

Sandcrest Family Medicine

Practice address

3203 Middle Dr
Columbus, IN 47203-4427

Phone

(812) 373-2701

Fax

(812) 373-2710

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. David J Porter, MD

Title

Medical Director

Phone

(812) 373-2701

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sandcrest Family Medicine Doing business as

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390780800000",
    "number": "1407861164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3203 MIDDLE DR",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472034427",
            "telephone_number": "812-373-2701",
            "fax_number": "812-373-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3203 MIDDLE DR",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472034427",
            "telephone_number": "812-373-2701",
            "fax_number": "812-373-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN PRACTICE ORGANIZATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2014-01-27",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "812-373-2701",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "207Q00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100051320A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sandcrest Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Candace Patricia Phillips, OTR
• Carissa Phillips
• Danielle Phillips, MS
• Veronica Phillips, RBT
• Stephanie Philyaw
• Physician Practice Organization (Kavelman Family Medicine)
• Physician Practice Organization Dba Columbus Medical
• Physician Practice Organization, (Southern Indiana OBGYN)
• Physician's Practice Organization (Columbus Gynecology and Adult Medicine)
• Physician's Practice Organization, Inc. D/B/a Columbus Pediatrics

• Family Medicine Physician in Columbus, IN
• Providers in Columbus, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2014; 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.