Organization Active NPI

Westside Adult Medicine, LLC

  • Internal Medicine Physician
  • Zionsville, IN
National Provider Identifier
1407959604
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WESTSIDE ADULT MEDICINE, LLC
Practice address
675 S Ford Rd
Zionsville, IN 46077-1825
Phone
(317) 873-5205
Fax
(317) 858-4168
NPI assigned
Sep 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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

Authorized official

Name
David Brown, MDNPI 1831292036
Title
Owner
Phone
(317) 873-5206

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

675 S Ford Rd
Zionsville, IN 46077-1825

Mailing address

PO Box 68952
Indianapolis, IN 46268-0952
Phone (317) 802-6291

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192665600000",
    "number": "1407959604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 68952",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462680952",
            "telephone_number": "317-802-6291",
            "fax_number": "317-870-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 S FORD RD",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460771825",
            "telephone_number": "317-873-5205",
            "fax_number": "317-858-4168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE ADULT MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-10-18",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-873-5206",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zionsville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; 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.